摘要
目的:通过测量股骨外科上髁轴线、股骨前后轴线及其股骨后髁轴线之间的夹角,探讨全膝关节置换术中定位股骨假体旋转力线的方法。方法:75侧正常成人股骨标本,性别、年龄不详,数码相机拍摄股骨远端轴位片并输入个人电脑,在Photoshop7.0.1软件中测量股骨外科上髁轴线与股骨后髁轴线之间的夹角(股骨后髁角,PCA)及前后轴线的垂线与股骨后髁轴线的夹角(APA),行配对资料的t检验,比较两角度的差异。结果:PCA均值3.67°±1.62°(0.75°～5.90°),与西方人数据及国人影像学测量数据接近;APA均值3.50°±1.40°(1.34°～5.65°),与PCA差异无统计学意义(t=0.949,P=0.359),此两个角度均有较大的变异性。结论:术中仅通过测量PCL进行旋转力线的定位可能导致截骨不准确,通过PCL、APL进行双重定位可以提高手术操作精度。
Objective： To measure the included angles between the surgical transepicondylar axis（STEA） and the posterior condylar line （PCL）, between the femoral anteroposterior line（APL） and PCL, and discuss the value of STEA, APL, and PCL as rotational alignment landmarks of the distal femur in total knee arthroplasty （TKA）. Methods： 75 normal femurs of Chinese adult cadavers were selected at random. Axial photo of every femur taken with a digital camera was inputed in a personal computer. Disposed with Photoshop 7.0.1 software, the included angle between the perpendicular line of APL and the PCL, noted as APA, together with the posterior condylar angles （PCA） between STEA and PCL were measured and compared with a [hired-Samples t-Test. Results： The values of PCA and APA were about 3.67°±1.62°（0.75°-5.90°） and 3.50°±1.40°（1.34°- 5.65°） respectively. There was no significant difference between these two angles （t=-0.949, P=-0.359）. Two angles showed wide variations considering their relatively small means. Conclusions： It was not accurate to determine the rotational alignment of the femoral component using PCL as a landmark. The authors suggest that using APL and STEA as double landmarks to check the rotational alignment of the femoral component for ensuring a proper rotational alignment in most TKA.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2007年第3期285-287,共3页
Chinese Journal of Clinical Anatomy
关键词
关节成形术
膝
股骨
力线
arthroplasty
knee
femur
alignment
