MRI辅助下膝关节骨关节炎患者股骨旋转轴线的准确性比较研究秦晓平.docVIP

MRI辅助下膝关节骨关节炎患者股骨旋转轴线的准确性比较研究 秦晓平 郭林 杨柳 王富友 陈昊 朱长宝 古凌川 李菲 武勇松 （第三军医大学西南医院关节外科中心，重庆 400038） 【摘要】 目的 在MRI上测量膝关节重度骨关节炎（osteoarthritis，OA）股骨远端不同旋转轴线，研究各参照轴线相对于外科经股骨上髁轴（surgical transepicondylar axis，STEA）的准确性。方法 回顾性的分析2013年6月～2014年1月在我中心明确诊断膝关节重度OA伴内翻畸形患者（内翻≤15°）86例86膝，其中男34例，女52例；年龄51-70岁﹝(63.7±8.7)岁﹞，由2位医生在MRI横断面图像上定位STEA、临床经股骨上髁轴（clinical transepicondylar axis,CTEA）、后髁线（posterior condylar line,PCL）外旋3°线(PCLS extorsion 3 ° line)、APL的垂线（perpendicular of anterior posterior line），测量各轴线相对于STEA偏差的角度，并用统计学方法（方差分析）比较各角度接近STEA的精确性。结果 PCL外旋3°线相对STEA外旋0.63°±1.82°、CTEA相对STEA外旋3.78°±0.75°, APL垂线相对STEA外旋5.38°±3.17°，精确度:AngleA(angle between PCLS extorsion 3 ° line and STEA)＞CSA （angle between CTEA and STEA）＞ASA（angle between perpendicular of APL and STEA） 【关键词】膝；关节置换；股骨旋转；PCL外旋3°线；磁共振 Comparative study on accuracy of the femoral rotation axis of osteoarthritis patients in knee assisted by MRI on method Qin Xiaoping,Guo Lin,Yang Liu,Wang Fuyou,Chen Hao,et al (Center for Joint Surgery,Southwest Hospital,Third Military Medical University，Chongqing,400038,P.R.China.Corresponding author:Yang Liu,E-mail:jointsurgery@163.com) 【Abstract】 Objective The study was aimed to measure the distal femur with different rotation axes in severe osteoarthritis(OA)of knee joint on MRI, and explore the accuracy of the reference to axis relative to the surgical transepicondylar axis（STEA）.Methods A retrospective analysis was performed on 86 cases who had severe OA in knee（86 knees）with varus deformity（varus deformity≤15°）between June 2013 and January 2014 in our Center for Joint surgery .There were 34 males（34 knees）and 52 females（52knees）,aged from 51 to 70 years（mean，63.7years）femoral condylar line（PCL）and the anterior posterior line（APL）by two surgeons respectively.Then observed the deviation relative to the STEA among PCLS extorsion 3 ° line，the CTEA, and the perpendicular of APL and used statistical methods (anova) to compare the accuracy of the Angle close to STEA. Results AngleA: 0.63°±1.82°,CSA: