全膝关节置换术后胫骨假体旋转角度测量方法的研究进展

Research progress on measurement methods of tibial prosthesis rotation angle after total knee arthroplasty

全膝关节置换术(TKA)是目前治疗终末期膝关节骨性关节炎最快速有效的方法,而胫骨假体的旋转角度是决定其临床效果的重要因素,也是TKA后临床效果的重要评价指标。虽然目前国内外学者基于X线、2D-CT、3D-CT或者MRI等常用影像学技术,参考胫骨假体后缘、胫骨结节、胫骨结节内侧1/3、髌腱、Akagi线等解剖标志,报道了Beger方案、Mayo方案、胫骨盘的前后轴到胫骨结节尖端的解剖距离和后外侧角锁定技术等都能对TKA术后胫骨假体旋转角度进行准确评估,但仍没有一种方法被公认为测量胫骨假体旋转角度的金标准。现就TKA后胫骨假体旋转角度的测量方法进行综述,旨在为关节外科医生在选择TKA后胫骨假体旋转角度的测量方法和进一步研究TKA术中胫骨假体旋转的最佳角度上提供参考。

Total knee arthroplasty(TKA)is currently the fastest and most effective method for the treatment of end-stage knee osteoarthritis,and the rotation angle of the tibial prosthesis is an important factor in determining its clinical efficacy,and it is also the of important evaluation index clinical efficacy after TKA.Although scholars at home and abroad are based on commonly used imaging techniques such as X-ray,2D-CT,3D-CT or MRI,refer to the anatomical landmarks such as posterior edge of tibial prosthesis,tibial tubercle,medial third of tibial tubercle,patellar tendon,Akagi line,reported that the Beger scheme,Mayo scheme,CTTT distance and PLCL technology can accurately assess the rotation angle of tibial prosthesis after TKA,but there is still no gold standard which is method recognized to measure the rotation angle of tibial prosthesis.This article summarizes the measurement methods of the rotation angle of the posterior tibial prosthesis in TKA,aiming to provide reference for the joint surgeon in choosing the measurement method of the rotation angle of the posterior tibial prosthesis in TKA and further research on the optimal angle of the tibial prosthesis rotation in TKA.