膝关节骨性关节炎患者中前髁连线与通髁连线的关系

The relation between the trochlear line and the clinical epicondylar axis in patients with knee-osteoarthritis

目的测定全膝关节置换术（TKA）患者的前髁连线（TL）、前后轴线（APL）、股骨后髁连线（PCL）与通髁连线（CEA）之间的角度，分析比较这3条参考轴线相对于CEA之间存在的变异度的差异。方法对接受右侧膝关节骨性关节炎Ⅳ期行TKA的36例患者进行右侧膝关节CT扫描，男11例，年龄60-81（69.1 ± 6.3）岁，女25例，年龄33-85（67.7 ± 12.2）岁。所获得的膝关节CT图像利用软件定位并测定TL、APL、PCL与CEA的角度。结果总体前髁-通髁角为（6.10 ± 3.22）°，前后轴-通髁角为（85.80 ± 2.86）°，后髁-通髁角为（2.70 ± 1.80）°。F检验显示，当以CEA作为角度测量的基线时，TL与APL及PCL相比较，其角度变异量比较差异无统计学意义（α=0.58、0.28）。结论在行TKA时，TL与APL、PCL一样可作为一条相对可靠的参考轴线来确定股骨假体的旋转对线。

Objective To determine the angles of trochlear line（TL）, antero-posterior line （APL） and posterior condylar line （PCL） with clinical epicondylar axis （CEA）, analyze the variability difference in 3 axes relative to CEA. Methods The right knees in 36 patients with knee osteoarthritis （grade IV） and who had underwent total knee arthroplasty were enrolled in this study, 11 male patients aged 60 - 81 （69.1 ± 6.3） years and 25 female patients aged 33 - 85（67.7 ± 12.2） years. All of right knees were scanned using computed tomography. The angles between the CEA and each of the 3 axes （TL, PCL, APL） were measured using software. Results The angles of TL-CEA, APL-CEA and PCL-CEA was （6.10 ± 3.22）°, （85.80 ± 2.86）° and （2.70 ± 1.80）°. The F tests showed that the angel invariability between the TL and CEA the APL axis （α= 0.58） or the PCL （α= 0.28） for referencing the CEA had no significant differences. Conclusions The TL can be a relatively reliable reference axis to determine rotational alignment of the femoral component similar to PCL and APL.