摘要
背景:Akagi线和试模复位技术(ROM)是全膝关节置换术中进行胫骨假体旋转定位的常用方法,但对此两种定位方法之间的差异性大小及来源仍缺乏相关研究。目的:比较内翻膝全膝关节置换术中Akagi线和ROM技术定位的差异,并探讨此差异产生的原因。方法:纳入2021年7-12月在广东省中医院大学城医院骨科行全膝关节置换且术前伴内翻畸形的70例患者,所有手术均应用后稳定型假体。术前通过X射线片测量股胫角、股骨远端外侧角、胫骨近端内侧角、胫骨股骨关节线夹角,并计算其与正常值的差异;术中测量Akagi线和ROM技术定位的差异角度α;通过相关性分析和多元线性回归分析法对术前测得的各角度和α进行统计学检验。结果与结论:①术前Δ机械股胫角为(10.90±4.82)°,Δ解剖股胫角为(10.81±4.34)°,Δ机械股骨远端外侧角为(-3.26±2.68)°,Δ解剖股骨远端外侧角为(-3.00±2.30)°,Δ机械胫骨近端内侧角为(2.39±3.05)°,Δ解剖胫骨近端内侧角为(2.98±3.31)°,Δ胫骨股骨关节线夹角为(4.71±2.52)°;术中测得的角度α为(2.39±2.50)°;②术中53例选择Akagi线、13例选择ROM技术进行旋转定位;③统计学分析结果提示,Δ机械胫骨近端内侧角、Δ解剖胫骨近端内侧角显著正向影响α角(P<0.01),回归方程分别为α=0.658+0.432×Δ机械胫骨近端内侧角;α=0.013+0.346×Δ解剖胫骨近端内侧角;④结果提示内翻膝全膝关节置换术中使用Akagi线和ROM技术进行旋转定位是存在一定差异的,且此差异(α)与胫骨近端内翻畸形程度大小呈正相关。
BACKGROUND:The Akagi line and range-of-motion(ROM)technique are widely used for locating the tibial prosthesis during total knee arthroplasty;however,there is still a lack of relevant research on the size and source of the difference between the two positioning methods.OBJECTIVE:To compare the differences of Akagi line and ROM technique in varus knee during total knee arthroplasty,and to discuss the causes of this difference.METHODS:Totally 70 patients with varus knee who underwent total knee arthroplasty in the Department of Orthopedics,Guangdong Hospital of Traditional Chinese Medicine from July to December 2021 were enrolled in this study.All operations were performed with the posterior cruciate-stabilizing total knee prostheses.The femorotibial angle,lateral distal femoral angle,medial proximal tibial angle,and joint line convergence angle were measured before operation.Its difference from normal was calculated.The angleαbetween Akagi line and ROM technique was measured during operation.The angles that measured preoperatively andαwere statistically tested by using correlation analysis and multiple linear regression analysis.RESULTS AND CONCLUSION:(1)Before operation,Δmechanical femoral-tibial angle was(10.90±4.82)°;Δanatomic tibiofemoral angle was(10.81±4.34)°;Δmechanical lateral distal femoral angle was(-3.26±2.68)°;Δanatomic lateral distal femoral angle was(-3.00±2.30)°;Δmechanical medial proximal tibial angle was(2.39±3.05)°;Δanatomic medial proximal tibial angle was(2.98±3.31)°;Δjoint line convergence angle was(4.71±2.52)°;theαthat measured during operation was(2.39±2.50)°.(2)Totally 53 cases selected Akagi line and 13 cases selected ROM technique for locating the tibial prosthesis finally.(3)Statistical analysis results showed thatΔmechanical medial proximal tibial angle andΔanatomic medial proximal tibial angle had a significant positive effect onα(P<0.01),and the regression equations wereα=0.658±0.432×Δmechanical medial proximal tibial angle andα=0.013±0.346×Δanatomic medial proximal tibial angle respectively.(4)The results suggest that there is a difference between Akagi line and ROM technique when locating the tibial prosthesis for patients with varus knee undergoing total knee arthroplasty,and this difference(α)is positively correlated with the degree of proximal tibial varus deformity.
作者
黄晖达
黄永明
周俊德
刘文渤
林跃玮
苏海涛
Huang Huida;Huang Yongming;Zhou Junde;Liu Wenbo;Lin Yuewei;Su Haitao(Second Clinical School of Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第13期2038-2043,共6页
Chinese Journal of Tissue Engineering Research
关键词
全膝关节置换
内翻畸形
胫骨假体
旋转定位
Akagi线
ROM技术
total knee arthroplasty
varus deformity
tibial prosthesis
rotational localization
Akagi line
ROM technique
