| 徐福稳,曹力,阿斯哈尔江·买买提依明,等.新疆多民族膝骨关节炎病人股骨后髁角的测量及其临床意义.骨科,2022,13(3): 193-197. |
| 新疆多民族膝骨关节炎病人股骨后髁角的测量及其临床意义 |
| Measurement and Clinical Significance of Posterior Condylar Angle of Femur in Multi-Ethnic Knee Osteoarthritis Patients in Xinjiang |
| 投稿时间：2021-12-23 |
| DOI：10.3969/j.issn.1674-8573.2022.03.001 |
| 中文关键词: 关节成形术，置换，膝 膝骨关节炎 多民族 股骨后髁角 CT MRI |
| 英文关键词: Arthroplasty, replacement, knee Knee osteoarthritis Multi-ethnic Posterior condylar angle CT MRI |
| 基金项目:新疆维吾尔自治区自然科学基金（2020D01C263）；国家自然科学基金（82160421）；国家自然科学基金青年基金（82002276） |
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| 中文摘要: |
| 目的 测量新疆地区多民族膝骨关节炎病人股骨后髁角（posterior condylar angle，PCA）并探讨其临床意义。方法 2020年1月至2020年12月，对我科收治的因膝骨关节炎行全膝关节置换术（total knee arthroplasty，TKA）的381例（729膝）病人行膝关节CT扫描，其中男103例，女278例；汉族223例，维吾尔族108例，哈萨克族50例；年龄为（68.5±7.3）岁（46~89岁）；左膝363个，右膝366个；其中259例（458膝）同时完善膝关节MRI扫描。通过与股骨机械轴垂直的断层图像测量外科经股骨上髁轴（surgical transepicondylar axis，STEA）和股骨后髁线（posterior condylar line，PCL），测量PCA值。比较不同民族、性别、侧别之间的PCA值。结果 根据MRI测得的PCA为2.97°±1.47°，根据CT测得的PCA为3.01°±1.49°，CT与MRI测量得到的PCA值比较，差异无统计学意义（P=0.732）。不同民族的PCA比较，汉族：3.13°±1.51°、维吾尔族：2.81°±1.48°、哈萨克族：2.85°±1.39°，汉族的PCA大于维吾尔族，差异有统计学意义（P=0.011）；不同侧别的PCA比较，左侧：3.16°±1.53°、右侧：2.85°±1.44°，左侧PCA大于右侧，差异有统计学意义（P=0.005）；男性与女性人群的PCA比较，差异无统计学意义（P=0.168）。维吾尔族男性病人的PCA小于女性，差异有统计学意义（P＜0.001）；汉族病人左侧的PCA大于右侧，差异有统计学意义（P=0.005）。结论 新疆地区膝骨关节炎病人行TKA时可采用CT或MRI测量PCA，以PCL外旋3°截骨可实现相对匹配的股骨旋转对线，汉族病人左膝PCL外旋截骨稍＞3°，维吾尔族男性病人PCL外旋截骨＜3°，提倡联合多种方法校准股骨旋转对线。 |
| 英文摘要: |
| Objective To explore the measurement and clinical significance of posterior condylar angle (PCA) of femur in multi-ethnic knee osteoarthritis patients in Xinjiang. Methods From January 2020 to December 2020, 381 patients (729 knees) who underwent total knee arthroplasty (TKA) due to knee osteoarthritis in our department were scanned by CT, including 103 males and 278 females, 223 cases of Han nationality, 108 cases of Uygur, 50 cases of Kazak. The age was (68.5±7.3) years (range: 46-89 years). There were 363 left knees and 366 right knees. Among them, 259 cases (458 knees) completed the MRI scan of knee joint at the same time. The surgical transcondylar axis (STEA) and posterior condylar line (PCL) were measured by the sectional images perpendicular to the mechanical axis of femur, and the PCA values were obtained. The PCA values of different nationalities, genders and sides were compared. Results The data of MRI and CI showed that the average PCA was 2.97°±1.47° and 3.01°±1.49° respectively, and there was no significant difference (P=0.732). The average PCA of Han, Uygur and Kazak nationalities was 3.13°±1.51°, 2.81°±1.48° and 2.85°±1.39° respectively. The PCA of Han nationality was greater than that of Uygur nationality, and the difference was statistically significant (P=0.011). The average PCA was 3.16°±1.53° on the left and 2.85°±1.44° on the right (P=0.005). There was no significant difference in PCA between males and females (P=0.168). The PCA of male Uygur patients was less than that of female (P＜0.001). The PCA of Han nationality on the left side was greater than that on the right side (P=0.005). Conclusion In terms of femoral rotation alignment in patients with knee osteoarthritis in Xinjiang, PCA can be measured by CT or MRI. Conventional reference PCL external rotation 3° osteotomy to achieve relatively matched femoral rotation alignment needs to consider side and ethnic factors. Among them, the left knee joint of Han patients needs conventional reference PCL external rotation slightly ＞3° osteotomy, and Uygur male patients need reference PCL external rotation ＜3°. At the same time, multiple methods should be combined to calibrate the femoral rotation alignment. |
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