Knee alignment in the transverse plane during weight-bearing activity and its implication for the tibial rotational alignment in total knee arthroplasty
Knee alignment in the transverse plane during weight-bearing activity and its implication for the tibial rotational alignment in total knee arthroplasty
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DOI：
10.1016/j.clinbiomech.2015.04.003
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发表时间：
2015-07-01
影响因子：
1.8
通讯作者：
Yang, Liu
中科院分区：
文献类型：
--
作者：
Yin, Li;Chen, Kaining;Yang, Liu
背景：膝关节在横断面上的排列方式对肢体的生物力学功能非常重要，也与全膝关节置换术的效果密切相关。本研究旨在评价负重活动时胫股在横向平面上的动态对齐情况。方法：采用双平面X线片和3D-2D配准技术，获得16名健康受试者负重屈曲0度~12度的膝关节运动学数据。取膝关节活动范围内多个屈曲角度的股骨前后轴线，用最小二乘法计算前后运动轴线。后者与文献中最常见的胫骨近端的六个表面来源的解剖轴线进行了比较。还量化了前后运动轴与胫骨结节的关系。结果：前后运动轴与所测试的六个解剖轴中的任何一个都不重合。相对于前者，它们的方位从外旋10.3度到内旋9.9度不等。在内侧边缘和内侧1/3点之间，前后运动轴倾向于与胫骨结节相交。解释：在功能性运动中，膝关节的横向对齐与胫骨结节的内侧1/3部分相关，而不是任何被测试的解剖轴线。这一区域可能有助于全膝关节置换术中胫骨假体的旋转对齐。(C)2015爱思唯尔有限公司。保留所有权利。
Background: The alignment of the knee in the transverse plane is important to the biomechanical functions of the lower limb, and is also associated with the outcomes of the total knee arthroplasty. This study aimed to evaluate the dynamic tibiofemoral alignment in the transverse plane during a weight-bearing activity.Methods: Knee kinematics of weight-bearing flexion from 0 degrees to 12 degrees was obtained in 16 healthy subjects utilizing biplanar radiography and 3D-2D registration techniques. The anteroposterior axes of the femur at multiple flexion angles in the range of knee motion were used to calculate the anteroposterior axis of motion using the least square method. The latter was compared to six surface-derived anatomical axes in the proximal tibia which were most commonly reported in the literature. The relationship between the anteroposterior axis of motion and the tibial tubercle was also quantified.Findings: The anteroposterior axis of motion did not coincide with any of the six anatomical axes tested. Their orientations varied from 10.3 degrees of external rotation to 9.9 degrees of internal rotation in relation to the former. The anteroposterior axis of motion tended to intersect the tibial tubercle between the medial border and the medial 1/3 point.Interpretation: Instead of any of the tested anatomical axes, the transverse knee alignment during functional movements is associated with the medial 1/3 portion of the tibial tubercle. This region may be helpful for the rotational alignment of the tibial components in total knee arthroplasty. (C) 2015 Elsevier Ltd. All rights reserved.