人工全膝关节置换术胫股旋转对线不良的研究

The application study on the malrotation between tibial and femoral components in TKA

目的探讨人工全膝关节置换术后胫股旋转对线不良的影响因素。方法分析80个正常成人膝关节的CT资料,测量临床上采用不同的股骨假体旋转参照轴可能引起的潜在的胫股旋转对线不良的角度。结果人工全膝关节置换术中各自独立地确定胫骨假体、股骨假体,其中股骨假体旋转分别以上髁轴线、前后轴线的垂线、后髁轴线外旋3°的直线来确定,可能产生的胫股旋转对线不良交角的平均值分别为4.54°、7.26°、4.88°。结论人工全膝关节置换术中各自独立确定胫骨假体、股骨假体的旋转对线会导致胫股旋转对线不良的产生,而上髁轴线及相对于后髁轴线外旋3°的直线产生的影响相对较小。

Objective It would explore the influencing factors of malrotation alignment of femoral component in TKA.Methods Analyse 80 CT images of normal human knees as subjects.Calculate potential malrotation scales between the femoral component and the tibial component by referencing to forementioned axes and their extent.Results Mark the tibial prosthesis and thc femoral prosthesis respectively in total knee arthroplasty and determine the rotational alignment of femoral component referencing to the transepicondylar axis and the hne perpendictdarity to anterior posterior line amd 3 degrees lateral rotated to the posterior condylar surfaces of the femur separately.The mean rotational mismatch angle between tibial component and femoral component was 4.54°. 7.26°, 4.88° respectively.Conclusions Respective land-arks were the intrinsic cause of the rotational mismatch in the total knee arthroplasty.The transepicondylar axis can be chosen as the optimal reference to decide the rotational alignment of the femoral component because of its minimal rotational mismatch between each component.