确定股骨远端旋转力线在膝关节置换中的意义  

The significance of determination for the reference axis of distal femur rotation in total knee arthroplasty

作　　者：纪小孟[1] 王健[1] 胡勇[1] 刘喜俊[1] 唐晓波[1] 陈海峰[1] 徐俊[1] 蒯剑波 

机构地区：[1]南通大学附属建湖医院骨科,江苏盐城224700

出　　处：《临床骨科杂志》2016年第6期689-692,共4页Journal of Clinical Orthopaedics

基　　金：盐城市医学科技发展计划项目(编号:YK2015073)

摘　　要：目的应用MRI测量探讨股骨远端各旋转轴线的关系,为人工全膝关节置换术(TKA)股骨远端旋转力线提供参考。方法选取苏浙地区健康汉族成人106例,膝关节共197个。对所选膝关节行MRI平扫,在MRI横断面图像上进行定位参照轴线,包括外科经股骨上髁轴线(STEA)、临床经股骨上髁轴线(CTEA)、前后轴线(APL)及股骨后髁轴线(PCL)。对轴线参数股骨后髁角(PCA)、髁扭转角(CTA)及前后轴线的垂线与后髁轴线的夹角(PAPA)进行测量。比较各角度不同性别、不同侧别均数的差异是否具有统计学意义。结果PCA平均为3.56°±0.26°,CTA平均为6.35°±0.72°,PAPA平均为4.08°±0.22°。不同性别、侧别的PCA均数差异无统计学意义(P>0.05),不同性别、侧别的CTA、PAPA均数差异有统计学意义(P<0.05)。结论应用MRI测量确定股骨远端轴线参数是一种可靠的方法,不同性别、侧别PCA相对恒定,STEA可作为TKA中股骨远端假体旋转参照力线。Objective To apply MRI technology to measure and study the relationship between the rotational axis of the distal femur, and to provide reference for distal femoral rotational alignment in total knee arthroplasty（TKA）. Methods Selected 106 cases of healthy adults in total of 197 knees in Jiangsu and Zhejiang province. MR scaned of the knee joints, positioning reference axis cross-sectional images on MRI, including the condylar axis （ STEA ） , through clinical femoral condyle axis （ CTEA） , around an axis （ APL） and the posterior condylar axis （ PCL） . Axis parameters were measured, including the femoral condyle angle （ PCA） , condylar twist angle （ CTA） and the angle between the vertical axis of the front and posterior condylar axis （ PAPA） , whether there was statistical significance a-mong these parameters of different gender, different sides. Results The measurement results were PCA average of 3. 56° ± 0. 26°,CTA average of 6. 35° ± 0. 72°, PAPA average of 4. 08° ± 0. 22°. Gender, other PCA side mean difference was not statistically significant （P〉0. 05）; gender, other side of the CTA, PAPA mean difference was statistically significant （P〈0. 05）. Conclusions Measured by MRI study to determine the parameters of the axis of the distal end of the femur is a reliable method,gender, lateralization PCA relatively constant, STEA as TKA distal femoral prosthesis rotational alignment.

关 键 词：磁共振成像 人工全膝关节置换术 股骨远端 旋转轴线 

分 类 号：R445.2[医药卫生—影像医学与核医学] R687.4[医药卫生—诊断学]