全膝关节置换术前应用双下肢全长摄影对不同体位下肢负重轴线的影响  

The effect of full-length photography of both lower extremities applied before total knee arthroplasty on weight-bearing axial alignment of the lower extremities at different positions

作　　者：廖煜胜 彭伟清 胡栢均[1] LIAO Yu-sheng;PENG Wei-qing;HU Bai-jun(Department of Medical Imaging,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528403,China)

机构地区：[1]广东省中山市中医院医学影像科,广东中山528403

出　　处：《实用医院临床杂志》2021年第1期171-173,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨全膝关节置换术前应用双下肢全长摄影对不同体位下肢负重轴线的影响。方法选择在我院接受全膝关节置换术患者138例,均拍摄两组双下肢全长正位片,一组以骨盆正中,下肢呈中立位为标准,另一组以膑骨正中,胫骨覆盖腓骨小头内1/3为标准方案。比较两种体位下的股骨胫骨机械轴夹角等数据,并评估两者图像质量。术后随访,比较术前术后膝关节功能。结果骨盆正中以及髌骨正中下摄影获得的股骨侧弓角(FBA)、机械股骨远端外侧角(mLDFA)以及近端内侧角(mMPTA)比较,差异均有统计学意义(P<0.05),且前者明显高于后者,但机械股胫角(mFTA)比较差异无统计学意义(P>0.05);两种体位下患者摄影图像质量比较差异无统计学意义(P>0.05);患者术后疼痛、功能、活动度、屈曲畸形和稳定性评分较术前均显著上升(P<0.05)。结论骨盆正中体位的双下肢全长摄影在全膝关节置换术的应用可正确展示患者本身该有的下肢力线,减小人为操作不当引起的误差,同时可以优化下肢力线在不同摄影体位的角度测量。Objective To investigate the effect of full-length photography of both lower extremities applied before total knee arthroplasty on weight-bearing axial alignment of the lower extremities at different positions.Methods One hundred and thirty-eight patients who underwent total knee arthroplasty in our hospital were enrolled in this study.Two sets of full-length frontal radiographs of both lower extremities were taken.One set of radiographs were taken with the center of the pelvis and the lower limb at neutral position as the standard.However,another set of radiographs was taken with the center of the patella and the tibia covering 1/3 of the fibular head as the standard.Data like the angle between femur and tibial mechanical axis at the two positions were compared,and the image quality was evaluated.Postoperative follow-up was performed to compare knee joint function before and after surgery.Results Statically significant differences were found in femoral bowing angle(FBA),mechanical lateral distal femoral angle(mLDFA)and mechanical medial proximal tibial angle(mMPTA)obtained by pelvic median and patella median photography(P<0.05),and those obtained by the former method were significant larger than those by the latter.However,no significant difference was found in the mechanical femorotibial angle(mFTA)(P>0.05).No significant differences were found in the quality of images taken at the two positions(P>0.05).After surgery,pain,function,range of motion,flexion deformity and stable type scores were increased significantly(P<0.05).Conclusion Application of full-length photography of both lower extremities at the median pelvic position before total knee arthroplasty can correctly display the patient's own lower limb force line,reduce the errors caused by improper operation,and optimize the angle measurement of lower limb force line at different photography positions.

关 键 词：全膝关节置换术 双下肢全长摄影 不同体位 下肢负重轴线 

分 类 号：R687[医药卫生—骨科学]