CORONAL ALIGNMENT AFTER TOTAL KNEE REPLACEMENT
CORONAL ALIGNMENT AFTER TOTAL KNEE REPLACEMENT
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DOI：
10.1302/0301-620x.73b5.1894655
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发表时间：
1991-09-01
影响因子：
--
通讯作者：
DENHAM, RA
中科院分区：
文献类型：
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作者：
JEFFERY, RS;MORRIS, RW;DENHAM, RA
马凯线从股骨头的中心到距骨体的中心。在长腿x光片上，这条线到膝关节中心的距离提供了冠状排列的最精确测量。错位会导致不正常的力量，这可能导致膝关节置换术后松动。我们报告了在1976年至1981年间进行的115例Denham膝关节置换术，使用最早设计的组件，插入髓内导棒。对患者进行临床评估，在手术前、术后不久以及长达12年后拍摄长腿站立x线片。在三分之二的膝关节（68%），Maquet线穿过假体的中间三分之一，术后松动的发生率为3%。当Maquet线位于其内侧或外侧时，误差约为+/- 3度，中位8年期间松脱的发生率为24%。这种差异非常显著（p = 0.001）。准确的冠状排列似乎是预防松动的重要因素。讨论了提高长腿x线机对准精度和测量精度的方法。
Maquet's line passes from the centre of the femoral head to the centre of the body of the talus. The distance of this line from the centre of the knee on a long-leg radiograph provides the most accurate measure of coronal alignment. Malalignment causes abnormal forces which may lead to loosening after knee replacement.We report a series of 115 Denham knee replacements performed between 1976 and 1981 using the earliest design of components, inserted with intramedullary guide rods. Patients were assessed clinically and long-leg standing radiographs were taken before operation, soon after surgery and up to 12 years later.In two-thirds of the knees (68%) Maquet's line passed through the middle third of the prosthesis on postoperative films and the incidence of subsequent loosening was 3%. When Maquet's line was medial or lateral to this, an error of approximately +/- 3-degrees, the incidence of loosening at a median period of eight years was 24%. This difference is highly significant (p = 0.001).Accurate coronal alignment appears to be an important factor in prevention of loosening. Means of improving the accuracy of alignment and of measuring it on long-leg radiographs are discussed.