股骨假体旋转对线技术对髌骨轨迹优化的临床研究

Clinical Study on Techniques of Rotational Alignment of Femoral Component Affecting Patella Tracking in Total Knee Arthroplasty

目的进行人工全膝关节置换术中股骨假体旋转对线技术对髌骨轨迹作用的随机化、前瞻性的临床研究。方法150例骨关节炎患者接受初次人工全膝关节置换术,其中40例接受双膝同期置换,密封信封抽样随机分组确定股骨假体旋转对线的参照标准,以"布巾钳试验"评价髌骨轨迹,决定是否作外侧支持带松解。结果股骨上髁轴组10个膝需行外侧支持带松解,股骨后髁轴组23个膝需行外侧支持带松解,两组差异有显著性(P<0·05)。结论股骨假体旋转对线对于髌骨轨迹的优劣有着显著影响,股骨上髁轴作为旋转对线的参照轴可以明显改善髌骨轨迹。

Objective To find a right way of the precise rotational alignment of the femoral components and to improve the patella tracking in total knee arthroplasty. Methods One hundred and fifty patients with knee osteoarthritis were selected. Among them, 40 patients were affected by their bilateral knees and received total knee replacements in both knees during the same operation time. All patients were randomly separated into two groups according to different rotational axis reference. A positive towel clip test as the indication for lateral retinscular release was performed after all components were implanted. Results There was significantly statistical difference between two groups （P 〈 0.05）. Conclusion The rotational alignment of the femoral components has a great influence on the patella tracking in total knee arthroplasty. It＇s reliable for surgeons to choose the transepieondylar axis as the reference axis to rotate femoral components so as to decrease the rate of the release of lateral retinaculum.