岳德波;李子荣;杨连发;王佰亮;

• 1:卫生部中日友好医院骨坏死与关节重建中心

摘要(Abstract)：

[目的]探讨中国北方地区人群股骨远端外旋角数值及与全膝关节置换术的结果关系。[方法]自1998年4月～2005年4月对84例106膝初次全膝人工关节置换术患者术前行CT检查。男性32例,女性52例。RA:48膝,OA∶67膝,色素沉着性滑膜炎1例。术前行CT检查,检查方法为平卧,下肢中立位,在股骨远端3mm密扫,并在屏幕上划线,将股骨两后髁连线,股骨内上髁凹与股骨外上髁连线,测量两线的夹角。并在手术中按测量角度进行股骨远段的截骨。术后6个月行检查,并测量关节活动度。与常规行3°截骨之术后关节活动度相比较。手术所用假体均为PFC,术者均为1人。[结果]国人股骨远端外旋角平均大于3°。男性为5.1(SD1.7),女性为5.8(SD1.5),依据CT测量结果行个性化股骨远端截骨术,效果优于常规3°外旋截骨。[结论]国人股骨远端旋转角度大于3°,手术中依据术前CT测量外旋角进行截骨手术,其术后效果优于常规的3°外旋截骨。

关键词(KeyWords)： 股骨髁;外旋角;全膝关节置换

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 岳德波;李子荣;杨连发;王佰亮;

Email:

DOI:

参考文献(References)：

• [1]Akaki M,Matusue Y,Mata T,et al.Effect of rotational alignment on patelar tracking in total knee arthriplasty[J].Clin Orthop,1999,366:155-163.
• [2]Nagamine R,Miura H,Bravo CV,et al.Anatomic variation should be considered in total knee arthroplasty[J].J Othop Sci,2000,5:232-237.
• [3]陈坚峰,冯宗权.膝关节置换术中股骨旋转截骨的研究进展[J].中国矫形外科杂志,2008,16:734-737.
• [4]吴蔚,许建中,郭漳生.成人正常股骨解剖测量及在膝关节置换术的临床意义[J].2006,14:200-212.
• [5]Martin A,von Strempel A.Two-year outcomes of computed tomo-graphy based and computed tomography free navigation for total knee arthroplasties[J].Clin Oryhop Relat Res,2006,449:275-287.
• [6]Yip DK,Zhu YH,Chiu KY,et al.Distal rotational Alignment of the Chinese femur and its relevance in total knee arthroplasty[J].J Athro-plasty,1:15-21.
• [7]Olcott CW,Scott RD.A comprasion of four intraoperative methrod to determine femoral component rotation during knee arthroplasty[J].J Arthropasty,2000,15:22-26.
• [8]Matsui Y,Kadoya Y,Uehera K,et al.Rotational deformity in varas os-teoarthritis of the knee:analysis with computed tomography[J].Clin Orthop Relat Res,2005,433:147-151.
• [9]Makani Al,Rand JA,Bryan RS,et al.Total knee arthroplasty with ki-nematic condylar prosyhesis.Aten-year follow-up study[J].J Bone Surg,1995,77:423-431.
• [10]Windsor RE,Insall JN,Urs WK,et al.Two-stage implantation for the salvege of total knee arthroplasty complicated by infection.Further fol-low-up and refirement of indications[J].J Bone Surg,1990,72:272-282.