新疆哈萨克族全膝关节置换术(TKA)中股骨远端旋转对线方法的研究

目的:探讨新疆哈萨克族正常股骨远端旋转对线标志的关系,为新疆哈萨克族临床TKA提供数据基础。方法:对80例哈萨克族志愿者160个正常膝关节进行MRI扫描,重建股骨远端模型,测量正常哈萨克族股骨远端轴线,分性别及侧别分组,分析两组间的差异有无统计学意义。结合临床探讨各轴线在TKA中的临床应用。结果:股骨后髁角范围0.55°～6.22°,平均(3.31°±1.34°);髁扭转角范围2.06°～7.82°,平均(5.13°±0.67°);前后轴线的垂线与后髁轴线夹角范围1.24°～6.15°,平均(4.61°±0.37°);前后轴线的垂线与外科上髁轴线夹角范围-1.29°～3.61°,平均(0.75°±0.32°);临床上髁轴线与外科上髁轴线夹角范围0.19°～4.72°,平均(2.72°±0.89°)。上述测量参数均不存在侧别差异。股骨后髁角、髁扭转角及前后轴线的垂线与外科上髁轴线夹角存在性别差异,其中股骨后髁角与髁扭转角男性大于女性,而前后轴线的垂线与外科上髁轴线夹角则为女性大于男性。结论:新疆哈萨克族人股骨远端旋转对线的解剖参数存在性别差异,但不存在侧别差异。在施行人工全膝关节置换术时,应当根据新疆哈萨克族人股骨远端形态特征、性别差异正确地选择对线标志,以确保患者在术后获得良好的治疗效果。

Study on Method of Distal Femur Rotational Alignment in Total Knee Arthroplasty(TKA) among Kazakh People in Xinjiang

Objective： To evaluate .the the Kazak normal distal femur rotation on the line mark,and provide the data base for the Xinjiang Kazakh clinical TKA. Mathods MRI scans on the 80 Kazakh volunteers 160 normal knee, reconstruction model of the distal femur, distal axis of the normal Kazakh femur is measured, by sex and side subsector analysis of whether the statistical significance of the difference between the two groups. Clinical investigate the clinical application of each axis in TKA. Results PCA：0.55° to 6.22° （range：3.31°± 1.34° ）;CTA： 2.06° to 7.82° ,（range： 5.13°±0.67° ）; APA： 1124° to 6.15° ,（range： 4.61° ± 0.37° ）; ATA-1.29 o to 3.61° ,（range： 0.75°± 0.32°）; CSA 0.19° to 4.72° , （range： 2.72°± 0.89° ）. The measured parameters do not exist lateraliza- tion. There are gender differences in terms of PCA, CTA and ATA, PCA and CTA were larger in male groups than of female group,while ATA in female group was larger than that of male group. Conclusion Kazak distal femur rotation anatomical parameters of the line there are gender differences, but there is no lateralization. Purposes of total knee arthroplasty, should be based on the distal femur morphological characteristics of the Kazak, gender differences correctly select and place the prosthesis, to ensure that patients in the postoperative good therapeutic effect.