人工全膝关节置换后股骨假体角度的CT影像学评估股骨外上髁线参照与间隙平衡技术的对比研究.pdfVIP

第16卷第12期 2 0 0 8年6月 中国矫形外科杂志 Orthopedic Journal of China VoL 16，No．12 JuIL2008 Computed tomographic evaluation of femoral component rotation in total knee arthroplasty：a comparison between trans—epicondylar and balanced gap techniques Shrinand V Vaidyal，Aditya V Maheshwari2，Rajesh M Gadhiyal，Vaibhav Bagarial，Amar S Ranawat2，Chitranjan S Ranawat2 1 Department ofOrthopedics，King Edward VII Memorial Hospital，Pard。Mumbai400012 Ind／a； 2 Ranawat Orthopedic Center，Lenox Hill Hospital，130 East 77n Street，11以floor，New York，NY，10021 USA Abstract：[Objective]To compare the actual femoral component rotation obtained by the TEA and BG techniques．[Methods] Thirty TKAB performed by TEA and BG techniques(15 each)welt廿evaluated prospectively by CT sc鲫for femoral component ro- tation a8 well鹪the Knee Society Scores(Kss)．[Result]The mean rotation in BG group was 2．70±1．1。and 5．60±1．6。in the TEA group(P=O．001)．The improvement in KSS for function wag significantly greater in the BG group than in the TEA group(P=0．002)，but there Was no difference in the KSS for knee(P=0．39)．[Conclusion]This study demonstrates that the use of the TEA technique for determining rotational alignment in IXA results in excessive external rotation of the femoral com- penent and poorer KSS for function compared tO the BG technique． Key words：total knee arthroplasty； femoral component rotation； ransepicondylar axis； balanced gap technique； flexion gap technique；tension gaP technique；ligament balance；soft tissue balance Chincfle Library Classification Number：R687 Document Code：A Article ID：1005—8478(2008)10—0908一05 人工全膝关节置换后股骨假体角度的CT影像学评估：股骨外上髁线参照与间隙平衡技术的对比研究 ／／1．印度盂买爱德华七世纪念医院骨科；2．美国纽约市Lenox Hill医院Ranawat骨科中心 摘要：【目的]虽然人工全膝关节置换术中假体旋转定位的重要性已得到公认，但术中以哪条轴线为参照能够 更加精确的保证股骨假体的旋转定位，目前尚存争议。研究表明股骨外上髁线(TEA)与膝关节屈曲轴线平行，但这 一轴线术中难以精确确定。本文采用间隙平衡技术(BG)，对比TEA技术在股骨假体实际旋转角度测量的差异。【方 法]30例人工全膝关节置换分为2组(每组15膝)，分别采用TEA和BG技术，术后行CT扫描测量股骨假体旋转角 度并行膝关节学会评分(KSS)。【结果】BG组中股骨假体平均外旋角度为2．7。4-1．1。，TEA组为5．6。±1．6。 (P=O．001)。术后KSS功能评分改善BG组高于TEA组(P=O．002)