临床外科杂志 ›› 2019, Vol. 27 ›› Issue (4): 305-308.doi: 10.3969/j.issn.1005-6483.2019.04.012

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股骨内外髁切迹定位全膝关节置换术中股骨髓内插入点的解剖学分析

  

  1. 江苏省苏州市立医院北区骨科(谢孝枫、顾雪平、王文晔);苏州市立医院骨科(郑斌)
  • 收稿日期:2018-08-22 出版日期:2019-04-20 发布日期:2019-04-20
  • 通讯作者: 郑斌,Email:winteradc@sina.cn

Anatomical study of the femur internal and external condyle notch line as the femoral intramedullary localization point used in total knee arthroplasty

  1. Department of Orthopedics,Suzhou Municipal Hospital,Suzhou 215000,China
  • Received:2018-08-22 Online:2019-04-20 Published:2019-04-20

摘要: 目的 通过研究股骨内、外髁切迹连线与股骨远端中心轴线的相对关系,证实以内、外髁连线作为膝关节置换股骨髓内定位点的可行性和准确性。方法 因膝关节骨性关节炎而行膝关节置换的病人64例,随机分为观察组和对照组,每组32例(32膝)。观察组术中根据股骨内、外髁切迹连线与股骨内侧髁外侧缘延长线交点作为股骨髓内定位进针点进行定位。对照组采用传统膝关节置换技术定位。观察应用两种定位点与股骨解剖轴线出口点的距离、术后股骨假体外翻角、下肢力线偏差。结果 股骨解剖轴线与髁间窝最高点前方的平均距离为(14.27±2.48)mm。观察组中定位点距股骨解剖轴线的平均距离为(1.1±0.37)mm,对照组定位点距股骨解剖轴线的距离平均为(3.22±1.45)mm,两组间比较差异有统计学意义(P<0.05)。术后测定两组下肢力线偏差及股骨假体的外翻角,观察组为(2.49±1.27)°,对照组为(3.81±1.74)°,两组比较差异有统计学意义(P<0.05)。股骨假体外翻角观察组为(88.6±2.71)°,对照组为(86.7±4.17)° ,两组比较差异有统计学意义(P<0.05)。结论 股骨内、外侧髁切迹连线与股骨内侧髁外侧缘延长线交点确定的股骨髓内插入杆定位点更精确、个体差异更小,可为术后获得良好的股骨假体力线提供保证。

关键词: 膝关节置换, 股骨内外髁切迹, 定位点, 解剖学

Abstract: Objective To study the feasibility and accuracy of the femur internal and external condyle notch line as the femoral intramedullary localization point used in total knee arthroplasty(TKA).Methods 64 patients with TKA were randomly divided into the observation group and the control group,32 cases(32 knees)in each group.The observation group was positioned according to the interlocking point between the internal and external condyle notch line and the extension line of the medial lateral condyle of femur.The control group was positioned with traditional technique.The distance between the location points and the anatomical axis of the femur,the femoral external rotation angle and the lower limb force line deviation were observed.Results The average distance between the anatomical axis of femur and the highest point of the intercondylar notch ceiling was(14.27±2.48)mm.The average distance in the observation group was(1.1±0.37)mm,and the distance in the control group was(3.22±1.45)mm,and there was significant difference between the two groups(P<0.05).The deviation of lower extremity force line and femoral prosthesis valgus angle were measured.In the observation group the deviation was(2.49±1.27)°,and the control group was(3.81±1.74)°,and there was significant difference between the two groups(P<0.05).In the observation group,the femur prosthesis valgus angle was(88.6±2.71)°,and the control group was(86.7±4.17)°.there was significant difference between the two groups(P<0.05).Conclusion The interlocking point between the internal and external condyle notch line and the extension line of the medial lateral condyle of femur was a more accurate position for the femoral intramedullary localization point used in total knee arthroplasty,it could provide a satisfactory postoperative femoral prosthesis alignment.

Key words: total knee arthroplasty, the femur internal and external condyle notch, localization point, anatomy

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