膝关节置换术后下肢力线和假体位置的测量方法及参考范围

Measurement Method and Reference Range of Lower Limb Alignment and Prosthesis Position after Knee Arthroplasty

全膝关节置换术(TKA)是一项成熟的可缓解和治疗终末期膝关节骨关节炎和类风湿关节炎的手段。TKA术后下肢力线的重建以及假体的位置均与患者术后的满意度、假体的长期生存率密切相关,也是决定其临床效果的重要因素和评价指标。临床可通过X线、二维CT(2D-CT)、三维CT(3D-CT)等影像学技术对TKA术后下肢力线和假体的位置进行测量和评估,但目前尚无公认的金标准。2D-CT测量较X线在分析假体位置或松动、假体周围骨吸收、骨折、感染等方面的敏感性更高,而3D-CT对于轴面旋转的测量具有独特优势。相信随着计算机导航和机器人辅助技术的发展,3D-CT测量会逐渐成为TKA术后常用的测量方法。

Total knee arthroplasty(TKA)is a mature method to relieve and treat end-stage knee osteoarthritis and rheumatoid arthritis.The reconstruction of the lower limb alignment and the position of the prothesis after TKA are closely related to the satisfaction of the patient and the long-term survival rate of the prothesis,which is also an important factor and evaluation index that determines its clinical effect.X-ray,2D CT,3D CT and other imaging techniques can be clinically used to measure and assess the lower limb alignment and the position of the prothesis after TKA,but there is still no recognized gold standard.2D-CT measurement is more sensitive than X-ray in analyzing prosthesis position or loosening,periprosthetic bone resorption,fracture,infection,etc.,while 3D-CT has unique advantages in the measurement of axial rotation.It′s believed that with the development of computer navigation and robot-assisted technology,3D-CT measurement will gradually become a commonly used method after TKA.