三维图像重建技术在髁部严重畸形膝关节置换术中的应用

Application of Three-dimensional Image Reconstruction Technology in Joint Replacement of Knee Joint with Severe Deformity Condyles

目的探讨三维图像重建技术在髁部严重畸形膝关节行置换术时的应用。方法术前对8例股骨髁严重畸形患者行膝关节三维图像重建，借助三维图像确定术中股骨假体外旋放置的角度，并以此角度行股骨髁外旋截骨，术后对患者进行随访。结果所有患者术前膝关节HSS评分平均为（39．1±6．9）分，术后膝关节HSS评分平均为（80．8±15．4）分，治疗前后有显著统计学差异（P〈0．01）；术前关节活动度为41．9°±10．8°，术后关节活动度为109．6°±21．5°，治疗前后比较差异有显著性（P〈0．01）。结论在髁部严重畸形膝关节行置换术时，术前行三维图像重建可为术中准确外旋放置股骨假体提供有效的帮助。

Objective To explore the function of 3-D reconstruction technique during TKA for the seriously damaged knees. Methods Reconstructed the 3-D images of knees joint of feuoral condyle with severe deformity for eight cases of patients before operation, then measured the appropriate angles by 3-D reconstructions preoperative and determine how much the femoral protheses should be externally rotationed,then rotation osteotomy by those measured angles, and followed patients postoperative. Results The average HSS score before operation was （39.1± 6.9）, much lower than the postoperation score 80.8 ± 15.4（P〈0.01）, and the average joint range of motion score before operation was 41.9± 10. 8° , much lower than the postoperation score 109.6° ± 21.5° （P〈0.01）. Conclusion For thoses whose knees had been seriously damaged, 3-D reconstruction could be used as a useful method to determine the femoral prothesis＇s rotation during TKA.