CT测量膝关节骨性关节炎患者下肢扭转角度的临床应用价值研究

Clinical Application Value of CT to Measure the Torsion Angle of Lower Limb in Patients with Knee Osteoarthritis

目的分析应用CT测量膝关节骨性关节炎患者下肢扭转角度在膝关节置换术前、随访中的临床意义。方法选取本院2018年4月至2019年5月收治且经临床确诊的46例膝关节骨性关节炎患者作为研究对象,通过测量患者术前、术后3个月回院复查膝扭转角度与胫骨扭转角度,并计算膝关节合并内、外翻畸形α角度,分析CT测量意义。结果92个膝关节中,合并内翻畸形65个,α角为+9.47°±9.16°;合并外翻畸形15个,α角为+10.58°±6.28°。92个膝关节中,α角>10°的有40个,其中18个α角>20°。左膝、右膝膝关节扭转角结果分别为9.16°±6.07°、8.74°±4.36°。左侧、右侧胫骨扭转角分别为26.75°±9.51°、27.30°±9.87°;膝关节置换术前患者膝关节扭转角1、膝关节扭转角2CT测量结果与患者术后复查中CT测量结果比较无明显差异(P>0.05)。结论利用CT测量膝关节骨性关节炎患者下肢扭转角度可为膝关节置换术中人工假体相对旋转定位提供可靠的参考径线,可作为术后复查随访的可靠手段之一。

Objective To analyze the clinical significance of CT in measuring the torsion angle of lower limb of patients with knee osteoarthritis before total knee arthroplasty and in follow-up.Method 46 patients who were admitted to our hospital from April 2018 to May 2019 and were diagnosed with knee osteoarthritis clinically were selected as the research object.The torsion angle of knee and torsion angle of tibia of the patients before operation and 3 months after the operation were measured,and theαangle of the knee joint combined with varus or valgus deformities was calculated,and the significance of CT measurement was analyzed.Results In the 92 knee joints,65 knee joints were combined with varus deformity.The angleαwas+9.47°±9.16°.15 knee joints were combined with valgus deformity.The angleαwas+0.508°±6.28°.In the 92 knee joints,there were 40 knee joints withαangle>10°,including 18 knee joints withαangle>20°.The torsion angles of the left and right knees joints were 9.16°±6.07°and 8.74°±4.36°,respectively.The torsion angles of the left and right tibia were 26.75°±9.51°and 27.30°±9.87°,respectively.There was no significant difference in the torsion angle 1 and torsion angle 2 of patients between the results of CT measurement before total knee arthroplasty and the results of CT measurement in postoperative reexamination(P>0.05).Conclusion Using CT to measure the torsion angle of the lower limbs of patients with knee osteoarthritis can provide a reliable reference line for the relative rotation positioning of artificial prostheses in total knee arthroplasty.It can be used as one of the reliable means for postoperative reexamination and follow-up.