Malrotation following Total Knee Arthroplasty (TKA) is directly related to poor outcome. Knowledge of the rotational axes (torsion) and angles is therefore important. The aim of the study was to determine whether an a...Malrotation following Total Knee Arthroplasty (TKA) is directly related to poor outcome. Knowledge of the rotational axes (torsion) and angles is therefore important. The aim of the study was to determine whether an association existed between the Femoral Anteversion Angle (FAA) Posterior Condylar Angle (PCA) and the Inferior Condylar Angle (ICA) in individuals. A CT scan of 50 (25 paired) cadaver femora was made. The FAA, PCA and ICA were measured. Statistical analysis of comparative relationships between these different angles was examined by calculating Pearson correlation coefficients and a paired t-test. The mean FAA, PCA and ICA for the whole group were respectively 11.7° (range 0 - 32, SD 8.2), 5.18° (range 0 - 12, SD 2.4) and 4.4° (range 0 - 10, SD 2.1). A correlation of 0.82 (p = 0.01) of the FAA was found between left versus right. For the overall group a correlation coefficient between the PCA of the left and right femur was r = 0.59, p = 0.01. The Pearson correlation between the FAA and PCA in the whole group was r = 0.27, p = 0.06. In females this was r = 0.54 (p = 0.03). Although the difference of the mean ICA and PCA was very small (0.7°), there was no correlation between these angles (r = 0.14, p = 0.23). In conclusion, one should be aware that, considering the weak correlation of the FAA and PCA, an individual rotational variation exists. Furthermore, no correlation was found between the PCA and ICA. Therefore, for now, this angle cannot be assumed to be helpful in TKA. A more individual approach in total knee arthroplasty seems essential for future TKA.展开更多
目的对比年龄≥30岁伴股骨前倾角异常增大(>40°)髋关节发育不良患者(developmental dysplasia of the hip,DDH)接受髋臼周围截骨术(periacetabular osteotomy,PAO)联合股骨近端去旋转截骨术(derotational osteotomy,PFDO)与单纯...目的对比年龄≥30岁伴股骨前倾角异常增大(>40°)髋关节发育不良患者(developmental dysplasia of the hip,DDH)接受髋臼周围截骨术(periacetabular osteotomy,PAO)联合股骨近端去旋转截骨术(derotational osteotomy,PFDO)与单纯PAO的手术效果。方法选取2012年1月至2020年1月在解放军总医院第四医学中心骨科医学部接受PAO联合PFDO的年龄≥30岁伴股骨前倾角异常增大(>40°)的DDH患者,共计55例,按照接受手术方式不同,分为联合手术组(n=29)和PAO组(n=26)。联合手术组接受PAO联合PFDO治疗,PAO组仅接受PAO治疗。比较两组患者的LCEA、ACEA、Tönnis角术前及术后1年的差异,比较两组患者术前、术后6个月、术后1年及末次随访(>2年)的改良Harris评分和iHot-12评分。结果共计随访55例患者,随访时间为2年1个月~9年11个月。术后6个月,联合手术组与PAO组的改良Harris评分和iHot-12评分相近(P>0.05)。术后1年及末次随访(>2年)的改良Harris评分和iHot-12评分,联合手术组优于PAO组(P<0.05)。结论对于年龄≥30岁伴股骨前倾角异常增大(>40°)的髋关节发育不良患者而言,PAO联合PFDO手术效果优于单纯PAO手术。展开更多
目的：探讨Pemberton手术治疗儿童发育性髋关节脱位（Developmental Dysplasia of the Hip,DDH）,髋臼指数（acetabularindex,AI）、前倾角、颈干角及关节囊等因素对手术治疗的影响。方法：回顾性分析2006~2010年采取Pemberton手术治疗D...目的：探讨Pemberton手术治疗儿童发育性髋关节脱位（Developmental Dysplasia of the Hip,DDH）,髋臼指数（acetabularindex,AI）、前倾角、颈干角及关节囊等因素对手术治疗的影响。方法：回顾性分析2006~2010年采取Pemberton手术治疗DDH 82例（98髋）,术前双侧髋关节行薄层平扫及3D重建测量AI、前倾角（femoral neck anteversion,FNA）及颈干角（collodiaphyseal angle,CDA）,指导术中行旋转截骨、造盖术及适当修整关节囊并行关节囊紧缩术,术后复查患儿AI、FNA及CDA,并随访12~48个月。结果：82例患儿得到随访,随访时间12~48个月,平均34个月。根据Mckay髋关节功能评分标准进行评价,优76髋（77.55%）,良16髋（16.32%）,可6髋（6.12%）,差0髋（0%）,AI平均缩小（17.5±0.7）度,FNA平均缩小（13.8±3.7）度,CDA平均缩小（13.0±3.5）度,采取SPSS17.0数据处理系统进行统计分析（t检验）,术后患侧的AI、FNA、CDA与术前相比差异均极有统计学意义（t〉t0.01,97,P〈0.01）。结论：对于儿童DDH行Pem-berton手术治疗,AI、FNA、CDA及关节囊是影响治疗效果的四个重要方面,AI、FNA的矫正有利于髋臼成形及维持髋关节稳定,CDA的矫正则有利于增加髋臼对股骨头的包容度,术中视关节囊具体情况适当的进行关节囊修整重建、紧缩术非常重要,对于股骨头的复位尤其是防止术后再脱位有重要作用。Pemberton手术治疗时常会涉及到其中的一个或全部,因此,术前准确评估,术中精确操作,对任何一方面的矫正适当与否均关系到术后疗效。展开更多
文摘Malrotation following Total Knee Arthroplasty (TKA) is directly related to poor outcome. Knowledge of the rotational axes (torsion) and angles is therefore important. The aim of the study was to determine whether an association existed between the Femoral Anteversion Angle (FAA) Posterior Condylar Angle (PCA) and the Inferior Condylar Angle (ICA) in individuals. A CT scan of 50 (25 paired) cadaver femora was made. The FAA, PCA and ICA were measured. Statistical analysis of comparative relationships between these different angles was examined by calculating Pearson correlation coefficients and a paired t-test. The mean FAA, PCA and ICA for the whole group were respectively 11.7° (range 0 - 32, SD 8.2), 5.18° (range 0 - 12, SD 2.4) and 4.4° (range 0 - 10, SD 2.1). A correlation of 0.82 (p = 0.01) of the FAA was found between left versus right. For the overall group a correlation coefficient between the PCA of the left and right femur was r = 0.59, p = 0.01. The Pearson correlation between the FAA and PCA in the whole group was r = 0.27, p = 0.06. In females this was r = 0.54 (p = 0.03). Although the difference of the mean ICA and PCA was very small (0.7°), there was no correlation between these angles (r = 0.14, p = 0.23). In conclusion, one should be aware that, considering the weak correlation of the FAA and PCA, an individual rotational variation exists. Furthermore, no correlation was found between the PCA and ICA. Therefore, for now, this angle cannot be assumed to be helpful in TKA. A more individual approach in total knee arthroplasty seems essential for future TKA.
文摘目的对比年龄≥30岁伴股骨前倾角异常增大(>40°)髋关节发育不良患者(developmental dysplasia of the hip,DDH)接受髋臼周围截骨术(periacetabular osteotomy,PAO)联合股骨近端去旋转截骨术(derotational osteotomy,PFDO)与单纯PAO的手术效果。方法选取2012年1月至2020年1月在解放军总医院第四医学中心骨科医学部接受PAO联合PFDO的年龄≥30岁伴股骨前倾角异常增大(>40°)的DDH患者,共计55例,按照接受手术方式不同,分为联合手术组(n=29)和PAO组(n=26)。联合手术组接受PAO联合PFDO治疗,PAO组仅接受PAO治疗。比较两组患者的LCEA、ACEA、Tönnis角术前及术后1年的差异,比较两组患者术前、术后6个月、术后1年及末次随访(>2年)的改良Harris评分和iHot-12评分。结果共计随访55例患者,随访时间为2年1个月~9年11个月。术后6个月,联合手术组与PAO组的改良Harris评分和iHot-12评分相近(P>0.05)。术后1年及末次随访(>2年)的改良Harris评分和iHot-12评分,联合手术组优于PAO组(P<0.05)。结论对于年龄≥30岁伴股骨前倾角异常增大(>40°)的髋关节发育不良患者而言,PAO联合PFDO手术效果优于单纯PAO手术。
文摘目的：探讨Pemberton手术治疗儿童发育性髋关节脱位（Developmental Dysplasia of the Hip,DDH）,髋臼指数（acetabularindex,AI）、前倾角、颈干角及关节囊等因素对手术治疗的影响。方法：回顾性分析2006~2010年采取Pemberton手术治疗DDH 82例（98髋）,术前双侧髋关节行薄层平扫及3D重建测量AI、前倾角（femoral neck anteversion,FNA）及颈干角（collodiaphyseal angle,CDA）,指导术中行旋转截骨、造盖术及适当修整关节囊并行关节囊紧缩术,术后复查患儿AI、FNA及CDA,并随访12~48个月。结果：82例患儿得到随访,随访时间12~48个月,平均34个月。根据Mckay髋关节功能评分标准进行评价,优76髋（77.55%）,良16髋（16.32%）,可6髋（6.12%）,差0髋（0%）,AI平均缩小（17.5±0.7）度,FNA平均缩小（13.8±3.7）度,CDA平均缩小（13.0±3.5）度,采取SPSS17.0数据处理系统进行统计分析（t检验）,术后患侧的AI、FNA、CDA与术前相比差异均极有统计学意义（t〉t0.01,97,P〈0.01）。结论：对于儿童DDH行Pem-berton手术治疗,AI、FNA、CDA及关节囊是影响治疗效果的四个重要方面,AI、FNA的矫正有利于髋臼成形及维持髋关节稳定,CDA的矫正则有利于增加髋臼对股骨头的包容度,术中视关节囊具体情况适当的进行关节囊修整重建、紧缩术非常重要,对于股骨头的复位尤其是防止术后再脱位有重要作用。Pemberton手术治疗时常会涉及到其中的一个或全部,因此,术前准确评估,术中精确操作,对任何一方面的矫正适当与否均关系到术后疗效。
