回顾性分析人工全膝关节置换术后早中期胫骨平台骨小梁方向变化  

Retrospective study on early and mid-term changes in trabecular orientation on tibial platform after total knee arthroplasty

作　　者：刘明昊[1] 何沛恒[1] 刘勇[1] 陈伟之[1] 叶永恒 李伟[1] 徐栋梁[1] LIU Minghao;HE Peiheng;LIU Yong;CHEN Weizhi;YE Yongheng;LI Wei;XU Dongliang(Department of Joint Surgery,The First Affiliated Hospital of Sun Yat sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院关节外科

出　　处：《实用医学杂志》2019年第20期3264-3268,共5页The Journal of Practical Medicine

基　　金：广东省省级科技计划项目(编号：2016A020220012);中山大学临床医学研究5010计划项目(编号：2010005)

摘　　要：目的测量在的站立位下肢全长X片中人工全膝关节置换术(total knee arthroplasty,TKA)后早中期胫骨平台假体周围的骨小梁方向,分析其变化规律和机制。方法回顾性分析2012年6月至2016年5月于我院进行TKA治疗的病例126例,收集病例术后、术后3个月、术后1、3、5年的固定旋转方向站立正位下肢全长X光照片,在所得照片上测量胫骨平台内外侧骨小梁角度、术后下肢力线、胫骨假体力,收集患者年龄、性别、BMI,并进行统计分析。结果病例胫骨平台内侧假体周围骨小梁角度于术后3个月平均减小了5.3°±2.65°,至术后1年平均减小8.3°±3.03°,外侧骨小梁角度于术后3个月平均减小了4.5°±1.71°,至术后1年平均减小7.6°±2.43°,1年后至术后3年、5年并无显著变化。术后下肢力线与胫骨平台内外侧骨小梁角度之间于术后1、3、5年均呈现出弱至中等程度的相关性。结论TKA术后下肢力线的纠正导致了胫骨平台骨小梁方向的改变,术后1年内胫骨平台骨小梁整体向垂直于胫骨假体平台的方向重构。Objective Measuring the trabecular orientation in the periprosthetic tibial platform in early and mid term rotation fixed weigh bearing full leg X rays of patients underwent total knee arthroplasty(TKA)and analysis of the pattern and mechanism of the trabecular realignment.Methods A retrospective analysis was conducted on the 126 cases underwent TKA in our institutione from June,2012 to May,2016.Rotation fixed weigh bearing full leg X rays taken at after surgery,3 months,1 year,3 years and 5 years follow up were obtained.Trabecular orientation in the medial and lateral periprosthetic tibial platform were measured on the X rays.Age,sex,BMI of patients were obtained and analyzed.Results The trabecular orientation around the medial prosthetic tibial platform decreased by an average of 5.3°±2.65°at 3 months and 8.3°±3.03°at 1 year after opera tion.The trabecular orientation around the lateral prosthetic tibial platform decreased by an average of 4.5°±1.71°at 3 months and 7.6°±2.43°at 1 year after operation.No significant changes from 1 year to 3 and 5 years after operation were observed.There was a weak to moderate correlation between the postoperative mechanical axis and the trabecular orientation in the medial and lateral prosthetic tibial platform at 1,3 and 5 years after operation.Conclusions Trabecular orientation in the tibia platform realigned due to the correction of the mechanical axis after TKA.Trabeculae in the periprosthetic tibial platform reconstructed within 1 year after TKA,tending to be perpendicular to the tibial plateau.

关 键 词：人工全膝关节置换术 骨小梁方向 下肢力线 Wolff定律 

分 类 号：R68[医药卫生—骨科学]