股骨内收肌结节作为膝关节翻修术中关节线定位标志的临床意义  

Clinical significance of adductor tubercle as a landmark to determine joint line in revision total knee arthroplasty

作　　者：肖隆艺[1] 禤天航 肖可明[1] 王刚[1] 付忠泉[1] 霍智铭[1] 

机构地区：[1]佛山市中医院骨科,528000 [2]广州中医药大学,510405

出　　处：《中华关节外科杂志（电子版）》2015年第4期9-12,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探究在膝关节翻修术中选用股骨内收肌结节作为关节线定位标志的可行性和有效性。方法回顾性分析2009年1月至2014年8月在我院完成的膝关节翻修手术20例,从X线正位上测量股骨内外上髁宽度(FW)和股骨内收肌结节(AT)至膝关节线(JL)的垂直距离(ATJL),计算比值,将比值接近正常膝关节生理比值(0.53)的10例归入匹配组,其余10例归入不匹配组,对比分析两组在术后6周、3个月、12个月的膝关节屈曲活动度(ROM)、KSS临床和功能评分以及并发症等方面是否存在差异。结果匹配组在膝关节活动度和KSS临床评分方面优于不匹配组,差异有统计学意义(P<0.01,P<0.05),术后KSS功能评分、并发症等方面差异无统计学意义(P>0.05)。结论将AT作为膝关节翻修术中确定JL的标志点这一方法有一定的可行性和有效性,可以成为临床医生的一种新思路,但其准确性仍需进一步的大样本随机对照试验来验证。Objective To discuss the feasibility and effectiveness of using the adductor tubercle as a landmark to determine the joint line level in revision total knee arthroplasty. Methods Twenty patients undergoing revision total knee arthroplasty in our hospital from January 2009 to August 2014 were analysed retrospectively. The trans-epicondylar femoral width（ FW） and the distances from the adductor tubercle（ AT） to the femur-tibia joint line（ JL）（ ATJL） were measured,and the ratio of ATJL and FW was calculated. Ten patients whose ratios were close to the physiological ratio were assigned to the matched group and the other 10 patients were assigned to the unmatched group. The range of motion（ ROM）,KSS clinical and function scores of the two groups in postoperatively six weeks,three months and 12 months were compared and analysed. Results ROM and KSS clinical scores of the matched group were significantly better than those of the unmatched group（ P〈0. 01,P〈0. 05）. But other data of the two groups were not significantly different（ P〉0. 05）. Conclusion It is valid and feasible to use the adductor tubercle as a landmark to determine the joint line level in revision total knee arthroplasty,which will give clinicians a new perspective,but more randomized controlled trials are necessary to verify its accuracy.

关 键 词：再手术 关节成形术 置换 膝 解剖学 

分 类 号：R687.4[医药卫生—骨科学]