正常成人股骨远端后髁角的测量及其临床意义  

The measurement of the posterior condylar angle in distal femur with clinical application in adult

作　　者：张华山[1] 翁文杰[1] 蒋青[1] 

机构地区：[1]南京大学医学院附属鼓楼医院关节病诊疗中心,210008

出　　处：《中华骨科杂志》2006年第4期252-255,共4页Chinese Journal of Orthopaedics

摘　　要：目的测量正常成人股骨远端后髁角,为国人行全膝关节置换术时的旋转对线提供参考数据。方法118例(186膝)膝关节无疾病、无畸形的苏皖地区成年人,男67例103膝,女51例83膝。年龄18～69岁,平均39.7岁。按年龄分成三组,A组18￣39岁(85膝),B组40￣59岁(73膝),C组≥60岁(28膝)。用CT扫描技术对股骨远端垂直于膝关节的机械轴进行薄层扫描,选取通过内、外上髁的CT扫描影像测定后髁角。结果男103膝,左侧57膝,右侧46膝;股骨远端后髁角:左侧5.9°±1.6°,右侧5.6°±2.6°,平均5.8°±2.2°。女83膝,左侧38膝,右侧45膝;股骨远端后髁角:左侧5.5°±2.5°,右侧5.2°±1.5°,平均5.3°±1.9°。各年龄组股骨远端后髁角:A组平均5.5°±1.9°,B组平均5.7°±1.8°,C组平均5.5°±2.7°。统计学分析表明,股骨远端后髁角在不同性别、侧别和年龄间比较,差异无统计学意义。结论苏皖地区成人正常股骨远端后髁角平均为5.6°±2.1°,明显大于西方人,且男女无差异。在对中国人进行全膝关节置换术时,依据股骨远端后髁线,参照欧美外旋3°的标准进行旋转对线可能会导致膝关节对线不良。Objective To investigate the posterior condylar angle （PCA） of distal femur in normal adult, and provide reasonable referenced parameters of the rotational alignment for the total knee arthroplasty in Chinese. Methods This study concluded 118 volunteers（186 knees） in Suwan area （67 males 103 knees, and 51 females 83 knees）, whose knees were healthy, without any malformation. The average age was 39.7 years（range, 18-69 years）. All subjects were divided into three groups according to the ages： group A, 18-39 years （85 knees）; group B, 40-59 years（73 knees）; group C, more than 60 years（28 knees）. The CT scan was employed to the mechanical axis which was perpendicular to the knee joint in the distal femur. The PCA was measured from the CT film across lateral and medial femoral epicondyle. The factorial design was used to compare the data among three groups. Results First, in the 103 knees of male, 57 in left side and 46 in right side. The PCA were 5.9°±1.6° in left side, 5.6°±2.6° in right side （mean, 5.8°±2.2°）. Then in the 83 knees of female, 38 in left side and 45 in right side, the PCA was 5.5°±2.5° in left side, 5.2°±1.5° in right side （mean, 5.3°±1.9°）. And the PCA was 5.5°±1.9° in group A, 5.7°±1.8° in group A, 5.5°±2.7° in group C, respectively, and there is no statistical significant difference in either gender or side and age. Conclusion The normal adult PCA of distal femur is 5.6°±2.1° in Suwan area, without difference in gender, which is beyond the Westems obviously. So in the total knee arthroplasty of Chinese, the malalignment will likely occur if the rotational alignment is performed according to Western style, the eversion 3° to the posterior condylar line in distal femur.

关 键 词：股骨 关节成形术 置换 膝 中国 

分 类 号：R687.4[医药卫生—骨科学]