Abstract
Objective:To explore clinical significance of rotational axis of distal femur on Chinese adults in total knee arthroplasty (TKA). Methods:There were 86 Chinese adults (106 normal knees) including 47 males (53 knees) and 39 fe-males (53 knees),54 knees were on left and 52 on right. The CT scan was employed in the distal femur. The scan direction was aligned to be on the plane perpendicular to the mechanical axis of the femoral. The CT images of cross sections across lateral and medial femoral epicondyle were moved to personal computer ,lateral angle between anterior posterior line (APL) and sur-gical transepicondylar axis (STEA) (ATA),lateral angle between posterior condylar line (PCL) and APL (APA),angle be-tween perpendicularity of APL and PCL (A-PA),posterior condylar angle (PCA),condylar twist angle (CTA),angle between clinical transepicondylar axis (CTEA) and STEA (CSA) were measured. These values were divided into different groups ac-cording to gender and side,the values of CTA,PCA,A-PA,angle PT (varus of tibia plateau),constant 3°,ATA,APA and con-stant 90° were compared by statistically. A-PA and PCA ,and CTA were analysed statistically with the liner regression ,the re-lationship among CTEA,STEA,PCL,APL and PLP were performed to assess by liner regression. Results:ATA was (89.79± 1.22)°,APA was (84.84±1.83)°,A-PA was (5.16±1.83)°,PCA was (4.80±1.23)°,CTA was (8.23±1.40)°,CSA was (3.45± 0.68)°. All the parameters had no differences on sex and side,but CSA had difference on male and female. There was no dif-ference among angle PT,PCA,A-PA. There was significant difference in CAT,constant 3° and angle PT,PCA,A-PA. There was no difference between ATA and constant 90° ,but there was difference between APA and constant 90°. There was relativity between PCA and CTA,and also PCA and A-PA,CTA and A-PA. There was significant relativity between STEA and CTEA, between STEA and APL,between STEA and PCL,and also between APLP,APL and PCL,but there was no significant relativity between PCL and CTEA. Conclusion:TKA for Chinese,the section of femoral posteriorcondyle should be external 5° to obtain the optimum rotational orientation. The property is different entirely between STEA and CTEA ,the rotational alignment is not performed according to parallel to the CTEA in distal femur. Among STEA ,APL,PCL,the STEA is the most reliable mark of rotational alignment of the distal femur ,and the PCL is the less reliable mark.关键词
股骨/关节成形术,置换,膝/体层摄影技术,X线计算机Key words
Femur/Arthroplasty,replacement,knee/Tomography,X ray computed
