下肢负重位DR片全长拼接对全膝关节置换术的评估

The evaluation of digital radiography full-length stitching film of lower limb at weight-bearing position on the total knee arthroplasty

目的探讨下肢负重位DR片全长拼接对全膝关节置换术术前计划及术后疗效评估的价值。方法采用西门子直接数字化X射线摄影系统行双下肢全长前后位摄片,应用西门子工作站Syngo MultiModality后处理软件多图像进行手动拼接处理,应用PACS系统对整个下肢骨骼的形态、生理角度、生理力线进行观察及分析;测量患者全膝关节置换术前、术后髋-膝-踝角及股骨下角。结果86例行髋关节至踝关节的双下肢全长拼接DR片均能清晰地显示在同一胶片上,且关节变形情况显示完整,图像质量可满足临床要求。肉眼观察患者全膝关节置换术术后较术前下肢骨骼形态及生理力线位置均明显改善。髋-膝-踝角及股骨下角术后1周均较术前明显改善,差异均有统计学意义(P<0.05)。结论下肢负重位全长拼接DR片可清晰显示双下肢全长,为全膝关节置换术术前全面了解下肢形态、术前术后测量生理力线、术后疗效评估提供依据。

Objective To investigate the value of digital radiography system(DR)full-length stitching film of lower limb at weight-bearing position on preoperative planning and postoperative efficacy evaluation of total knee arthroplasty.Methods The Siemens DR was used to take full-length anterior and posterior photographs of both lower limbs,and the Siemens workstation Syngo MultiModality post-processing software was used for manual stitching of multiple images.The PACS system was used to observe and analyze the morphology,physiological angle,and physiological force lines.The hip-knee-ankle angle and femoral inferior angle of patients before and after total knee arthroplasty were measured.Results The 86 cases of full-length stitching DR films of both lower limbs from hip to ankle could be clearly displayed on the same film,and the joint deformation was displayed intactly,and the image quality could meet the clinical requirements.The bone morphology of the lower limbs and the position of the physiological force line were significantly improved after total knee arthroplasty.Hip-knee-ankle angle and femoral inferior angle were significantly improved at 1 week after operation,compared with the preoperation,the difference was statistically significant(P<0.05).Conclusions The full-length stitching DR film at the weight-bearing position of lower limbs can clearly show the full-length of both lower limbs,which provides the basis for a comprehensive understanding of lower limb morphology and measurement of pre-and post-operative physiological force lines before knee arthroplasty,and the evaluation of postoperative efficacy.