终末期膝内翻骨关节炎患者胫骨内翻与股骨旋转的相关性

Correlation of Tibia Vara and Femoral Rotation of Patients with End-Stage Osteoarthritis of Genu Varus

目的探讨手术治疗的膝内翻患者术前影像资料中胫骨内翻与股骨旋转的相关性。方法选取2017年1月至2019年1月在医院行膝关节置换的下肢全长片中力线内翻的骨关节炎患者136例,排除存在膝关节屈曲畸形患者28例,较大骨赘患者12例,最终入组96例。均行下肢全长片膝关节CT检查。在CT上测量股骨远端扭转角(CTA,临床通髁线-股骨后髁连线夹角),在下肢全长片上测量胫骨近端内翻角(PTA,胫骨机械轴的垂线与胫骨平台切线的夹角)。采用SPSS软件分析CTA与PTA的相关性。结果96例患者中,男32例(33.33%),女64例(66.67%),年龄52~86岁,平均69.8岁;CTA均值为(4.83°±1.02°),PTA均值为(7.24°±2.36°),CTA与PTA的相关性检验结果无显著相关性(P=0.088>0.05);年龄与PTA的相关性检验结果有显著相关性(P=0.000<0.05),相关性系数为0.358;年龄与CTA相关性检验结果无显著相关性(P=0.690>0.05)。结论胫骨近端和股骨旋转退变程度不一,终末期膝内翻骨关节炎的患者胫骨近端内翻角与股骨远端的旋转无相关性,PTA不是股骨旋转好的预测因素。

Objective To investigate the relevance of tibia vara and femoral rotation in imaging examination data of genu varum patients who prepared to be treated by surgery.Methods A total of 136 patients with osteoarthritis with medial line of force varus in full-length radiographs of lower limbs who received knee arthroplasty in the hospital from January 2017 to January 2019 were selected,28 patients with knee flexion deformity and 12 patients with larger osteophytes were excluded,96 patients enrolled.All of them underwent CT examination of knee joint with full length film of lower limb and the distal femoral torsion angle(CTA,the included angle between the clinical condylar line and the posterior femoral condyle line)was measured by CT,and the proximal tibial varus angle(PTA,the included angle between the vertical line of the tibial mechanical axis and the tangent line of the tibial platform)was measured on the full length film of the lower limb.The correlation between CTA and PTA was analyzed by SPSS software.Results Among 96 patients,32 cases of male(33.33%)and 64 cases of female(66.67%),the patients′age was mainly from 52 to 86 years old,with an average of 69.8 years old,the average value of CTA was(4.83°±1.02°),the average value of CTA was(7.24°±2.36°).There was no significant correlation of CTA and PTA(P=0.088>0.05).There was a significant correlation between the age and PTA(P=0.000<0.05),the correlation coefficient was 0.358.There was no significant correlation between the age and CTA(P=0.690>0.05).Conclusion The degree of the proximal tibia and femur rotation degeneration is different.There is no correlation between the proximal tibial varus angle and distal femoral rotation of patients with terminal genu varus osteoarthritis.PTA is not a good predictor of femoral rotation.