CT扫描确定全膝关节置换股骨假体旋转力线的研究  

Determining the femoral prothesis rotational certification by CT in total knee arthroplasty

作　　者：孙振辉[1] 刘军[1] 张宇[1] 孙云波[1] 曹建刚[1] 王磊[1] 田孟强[1] 王沛[2] 

机构地区：[1]天津市人民医院关节外科,天津300121 [2]天津医科大学总医院骨科,天津300052

出　　处：《临床骨科杂志》2009年第5期501-503,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨术前CT扫描对全膝关节置换(TKA)中股骨假体旋转力线精确确定的作用。方法将200例(252膝)TKA患者随机分为两组:①经验组(64例):TKA术中根据术者触摸外科股骨上髁轴线联合Whi-teside线联合确定股骨假体外旋角度;②CT扫描组(136例):术前CT扫描确定股骨后髁角,术中采用可调外旋定位器复制CT确定的外旋角度,其余TKA手术操作相同。两组术后均行CT扫描确定股骨假体旋转不良角度并对其绝对值进行比较。结果经验组TKA术后股骨假体旋转不良角度为2.8°±0.14°,CT扫描组为1.2°±0.04°,两组比较差异有统计学意义(t=4.18,P<0.01)。经验组股骨假体旋转不良率为32.1%,CT扫描组为18.5%,两组比较差异有统计学意义(χ2=17.47,P<0.01)。结论术前CT扫描确定股骨远端后髁角可以有效提高TKA手术股骨假体旋转力线,方法简单、有效、重复性良好。Objective To analyses the effect of CT for determining femoral prothesis rotational certification in total knee arthroplasty.Methods 200 cases（252 knees） of total knee arthroplasty were randomly divided into two groups：Experience group（64 cases）：femoral prothesis rotational certification was depended on the palpation of the femoral epicondyle axes combined with Whiteside line in operation.CT scan group（136 cases）：femoral prothesis rotational certification was depended on the preoperation CT scan,by which could modulate the lateral rotation angle.The other procedure was same to the standard TKA.In order to confirm the femoral prothesis rotational angle and to compare to the absolute value,CT scan was done for all cases.Results Femoral prothesis rotation angle was 2.8°±0.14° in the experience group and 1.2°±0.04° in CT scan group,there was significant difference between the two groups（t=4.18,P〈0.01）.The malrotation ratio was 32.1% in the experience group,while the CT scan group was only 18.5%,there was statistic difference between the two groups（χ^2=17.47,P〈0.01）.Conclusions Ensuring the femoral epicondyle axes by the preoperative CT scan is an effective way to determine the femoral prothesis rotational angle.

关 键 词：全膝关节置换 股骨假体 旋转力线 

分 类 号：R739.4[医药卫生—肿瘤] R687.4[医药卫生—临床医学]