摘要
背景:膝关节置换时股骨髓内定位精确度要求高,操作复杂,选择更精确的定位方法及确定正确的进针点对于假体及关节功能都十分重要。目的:膝关节置换时观察应用不同股骨髓内定位方法时进针点位置对假体排列的影响。方法:选择2012年1月至2015年7月在常熟第一人民医院接受膝关节置换的80例患者,按照随机数字法分为试验组和对照组,每组40例。试验组利用CT扫描进行股骨髓内定位,借助影像学参数对股骨髓内定位进入点的理论位置进行标记。对照组采用传统膝关节置换技术对股骨髓内定位进入点进行标记。观察应用不同股骨髓内定位方法时进针点的位置,探讨膝关节置换时股骨髓内定位对假体排列的影响。结果与结论:与对照组相比,试验组正侧位X射线片上进入点到股骨解剖线的距离更短,股骨假体外侧角及膝关节生理外翻角更接近理论值,股骨轴线与股骨髁交点与滑车中心的距离更短,差异均有显著性意义(P<0.05)。结果证实,三维CT扫描模拟定位与传统二维骨髓内定位相比进针点位置更为准确,多集中于髁间窝偏内2-5 mm,髁间窝偏前3-10 mm,三维CT扫描模拟定位是股骨髓内定位可靠的选择。
BACKGROUND： The femoral intramedullary guides in total knee arthroplasty require high precision, complex operation, it is very important for prosthesis and joint function to choose more precise positioning method and determine the correct needle point. OBJECTIVE： To study the effect of needle point position on prosthesis arrangement when applying different femoral intramedullary guides methods in total knee arthroplasty. METHODS： Totally 80 patients who received the treatment of total knee arthroplasty in Changshu No.1 People＇s Hospital from January 2012 to July 2015 were selected and divided into test and control groups according to random number table（n=40/group）. The patients in the test group accepted CT scan for femoral intramedullary guides. The theoretical position of femoral intramedullary guides entry point was marked usingradiographic parameters. In the control group, the traditional total knee arthroplasty technology was used to mark the entry point of femoral intramedullary guides. The needle point position when applying different femoral intramedullary guide methods was observed. The effect of femoral intramedullary guides on prosthesis arrangement in total knee arthroplasty was discussed. RESULTS AND CONCLUSION： Compared with the control group, the distance from entry point to femoral anatomic line on positive and lateral X-ray film in the test group was shorter, femoral prosthesis lateral angle and physiological valgus angle were closer to the theoretical value, distance from intersection of femur axis and femoral condyle to block center was shorter; the differences were statistically significant（P〈0.05）. These results demonstrate that compared with the traditional two-dimensional intramedullary positioning, the needle point position of three-dimensional CT scan stimulative positioning is more accurate. The location more concentrates on within intercondylar fossa 2-5 mm, more front of intercondylar fossa 3-10 mm, three-dimensional CT scan stimulative positioning is a reliable choice for femoral intramedullary guides.
出处
《中国组织工程研究》
CAS
北大核心
2016年第4期481-485,共5页
Chinese Journal of Tissue Engineering Research
