Purpose: To restore the normal axial alignment of the lower extremity is important in reconstructive knee surgery. The aim of this study was to evaluate lower-limb alignment and posterior tibial slope. Methods: Thirty...Purpose: To restore the normal axial alignment of the lower extremity is important in reconstructive knee surgery. The aim of this study was to evaluate lower-limb alignment and posterior tibial slope. Methods: Thirty-two male and 32 female outpatients aged 22 to 46 were recruited. A full weight-bearing anteroposterior radiograph of the entire lower limb was obtained for each subject. The axial alignment was measured based on the centers of the femoral head, knee, and ankle. The tibiofemoral (TF), tibial joint (TJ), and posterior tibial slope (TS) angles were determined. Results: The mean TF angle was more varus in women (177.8°) than men (179.2°), and the mean TJ angle was more medially inclined in women than men. Women had a greater TJ angle than men (93.3° vs. 91.6°). The mean posterior TS was greater in men than women (16.0° vs. 12.5°, p < 0.05), while the mean TS angle was greater in women (14.8°) than men (12.3°). Conclusion: Knee alignment and geometry vary among populations. In our study, the TF angle was varus among all participants. The knee joint was more medially inclined in women than men. And also the posterior TS was greater in women than men.展开更多
Background: Sagittal plane placement of the tibial component in total knee replacement (TKR) has important implications for maximizing the range of flexion motion, allowing collateral ligaments to function more normal...Background: Sagittal plane placement of the tibial component in total knee replacement (TKR) has important implications for maximizing the range of flexion motion, allowing collateral ligaments to function more normally, as well as providing ideal compressive loading on the tibial bone-prosthesis interface. This study attempts to quantify the normal posterior tibial slope (PTS) angle pre-operatively and post-operatively in osteoarthritic patients after using a conventional extramedullary tibial resection guide to assess its effectiveness. Methods: Forty-nine primary cementless total knee replacements in 34 osteoarthritic patients were measured radiographically pre-operatively and one year post-operatively to determine the PTS and its effect on range of motion. Lateral X-rays, using the anterior cortical line of the tibia, were employed for all measurements. Results: Pre-operative PTS measured 11.83˚ (range 5˚ - 18˚), while post-operative PTS of implanted tibial components measured 11.30o (range 4˚ - 18˚). The pre-operative range of motion of 112˚ (range 30˚ to 135˚) was improved to 119˚ (range 90˚ to 135˚) post-operatively after 1 year. Conclusions: Anterior tibial shaft referencing using a conventional extramedullary tibial resection guide provides an easy and convenient method for reproducing the anatomical PTS during TKR. This methodology provided improvement in average range of motion from 112˚ pre-operatively to 119˚ post-operatively at one year.展开更多
目的研究内侧开放楔形胫骨高位截骨术(opening-wedge high tibial osteotomy,OWHTO)治疗膝骨关节炎(knee osteoarthritis,KOA)术中矢状面楔形撑开对胫骨平台后倾角(posterior tibial slope,PTS)的影响。方法回顾性分析2019年1月至2020年...目的研究内侧开放楔形胫骨高位截骨术(opening-wedge high tibial osteotomy,OWHTO)治疗膝骨关节炎(knee osteoarthritis,KOA)术中矢状面楔形撑开对胫骨平台后倾角(posterior tibial slope,PTS)的影响。方法回顾性分析2019年1月至2020年7月,山东省中医院运动损伤骨科接受OWHTO治疗的63例KOA患者的临床资料。研究组31例,其中男13例,女18例;年龄50~65岁,平均(56.29±3.49)岁;身体质量指数(body mass index,BMI)为(26.48±1.77)kg/m~2;按照上下1/2~2/3的近似比例在矢状面楔形撑开截骨间隙。对照组32例,男14例,女18例;年龄49~59岁,平均(55.66±2.66)岁;BMI(27.13±2.39)kg/m~2;常规撑开间隙。术前两组患者性别、年龄、BMI、疼痛视觉模拟评分(visual analogu scale,VAS)、美国特种外科医院(hospital for special surgery,HSS)评分、Lysholm评分、PTS等差异均无统计学意义(P>0.05)。术后1周之内首次拍片和末次随访时测量PTS并与术前比较;术前及末次随访时采用VAS评分、HSS评分和Lysholm评分评估患者膝关节疼痛及功能情况。结果两组患者均获随访,随访时间22~32个月,平均(26.81±2.12)个月。两组患者均未出现血管神经损伤、下肢静脉血栓形成等并发症。末次随访时,两组患者VAS评分、HSS评分和Lysholm评分均较术前显著改善,差异有统计学意义(P<0.05);但组间各评分在各时间点的比较,差异均无统计学意义(P>0.05)。研究组各时间点PTS差异均无统计学意义(P>0.05);对照组术后及末次随访时PTS较术前明显增加(P<0.05);术后及末次随访时研究组患者PTS均显著小于对照组,差异有统计学意义(P<0.05)。结论采用OWHTO治疗KOA能有效缓解膝关节疼痛并改善其功能,且通过矢状面楔形撑开可有效避免PTS的增加。展开更多
文摘Purpose: To restore the normal axial alignment of the lower extremity is important in reconstructive knee surgery. The aim of this study was to evaluate lower-limb alignment and posterior tibial slope. Methods: Thirty-two male and 32 female outpatients aged 22 to 46 were recruited. A full weight-bearing anteroposterior radiograph of the entire lower limb was obtained for each subject. The axial alignment was measured based on the centers of the femoral head, knee, and ankle. The tibiofemoral (TF), tibial joint (TJ), and posterior tibial slope (TS) angles were determined. Results: The mean TF angle was more varus in women (177.8°) than men (179.2°), and the mean TJ angle was more medially inclined in women than men. Women had a greater TJ angle than men (93.3° vs. 91.6°). The mean posterior TS was greater in men than women (16.0° vs. 12.5°, p < 0.05), while the mean TS angle was greater in women (14.8°) than men (12.3°). Conclusion: Knee alignment and geometry vary among populations. In our study, the TF angle was varus among all participants. The knee joint was more medially inclined in women than men. And also the posterior TS was greater in women than men.
文摘Background: Sagittal plane placement of the tibial component in total knee replacement (TKR) has important implications for maximizing the range of flexion motion, allowing collateral ligaments to function more normally, as well as providing ideal compressive loading on the tibial bone-prosthesis interface. This study attempts to quantify the normal posterior tibial slope (PTS) angle pre-operatively and post-operatively in osteoarthritic patients after using a conventional extramedullary tibial resection guide to assess its effectiveness. Methods: Forty-nine primary cementless total knee replacements in 34 osteoarthritic patients were measured radiographically pre-operatively and one year post-operatively to determine the PTS and its effect on range of motion. Lateral X-rays, using the anterior cortical line of the tibia, were employed for all measurements. Results: Pre-operative PTS measured 11.83˚ (range 5˚ - 18˚), while post-operative PTS of implanted tibial components measured 11.30o (range 4˚ - 18˚). The pre-operative range of motion of 112˚ (range 30˚ to 135˚) was improved to 119˚ (range 90˚ to 135˚) post-operatively after 1 year. Conclusions: Anterior tibial shaft referencing using a conventional extramedullary tibial resection guide provides an easy and convenient method for reproducing the anatomical PTS during TKR. This methodology provided improvement in average range of motion from 112˚ pre-operatively to 119˚ post-operatively at one year.
文摘目的研究内侧开放楔形胫骨高位截骨术(opening-wedge high tibial osteotomy,OWHTO)治疗膝骨关节炎(knee osteoarthritis,KOA)术中矢状面楔形撑开对胫骨平台后倾角(posterior tibial slope,PTS)的影响。方法回顾性分析2019年1月至2020年7月,山东省中医院运动损伤骨科接受OWHTO治疗的63例KOA患者的临床资料。研究组31例,其中男13例,女18例;年龄50~65岁,平均(56.29±3.49)岁;身体质量指数(body mass index,BMI)为(26.48±1.77)kg/m~2;按照上下1/2~2/3的近似比例在矢状面楔形撑开截骨间隙。对照组32例,男14例,女18例;年龄49~59岁,平均(55.66±2.66)岁;BMI(27.13±2.39)kg/m~2;常规撑开间隙。术前两组患者性别、年龄、BMI、疼痛视觉模拟评分(visual analogu scale,VAS)、美国特种外科医院(hospital for special surgery,HSS)评分、Lysholm评分、PTS等差异均无统计学意义(P>0.05)。术后1周之内首次拍片和末次随访时测量PTS并与术前比较;术前及末次随访时采用VAS评分、HSS评分和Lysholm评分评估患者膝关节疼痛及功能情况。结果两组患者均获随访,随访时间22~32个月,平均(26.81±2.12)个月。两组患者均未出现血管神经损伤、下肢静脉血栓形成等并发症。末次随访时,两组患者VAS评分、HSS评分和Lysholm评分均较术前显著改善,差异有统计学意义(P<0.05);但组间各评分在各时间点的比较,差异均无统计学意义(P>0.05)。研究组各时间点PTS差异均无统计学意义(P>0.05);对照组术后及末次随访时PTS较术前明显增加(P<0.05);术后及末次随访时研究组患者PTS均显著小于对照组,差异有统计学意义(P<0.05)。结论采用OWHTO治疗KOA能有效缓解膝关节疼痛并改善其功能,且通过矢状面楔形撑开可有效避免PTS的增加。
