Coronal alignment is a predictor of the rotational geometry of the distal femur in the osteo-arthritic knee
Coronal alignment is a predictor of the rotational geometry of the distal femur in the osteo-arthritic knee
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DOI：
10.1007/s00167-012-2306-x
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发表时间：
2013-10-01
影响因子：
3.8
通讯作者：
Victor, J.
中科院分区：
文献类型：
--
作者：
Luyckx, T.;Zambianchi, F.;Victor, J.
股骨远端的旋转解剖结构存在很多个体间差异。本研究旨在明确膝关节骨性关节炎患者股骨远端的旋转解剖结构，并探讨其与整体冠状面对线和性别的关系。后髁线（PCL）相对于手术经髁上轴（sTEA）平均内旋1.6A度（SD 1.9）。垂直于转子前后轴（aSyenTRAx）相对于sTEA平均外旋4.8A度（SD 3.3A度）。不同冠状面对线组中，PCL和sTEA之间的关系存在统计学差异（p < 0.001）：内翻膝关节为1.0A度（SD 1.8A度），中立膝关节为2.1A度（SD 1.8A度），膝关节外翻为2.6A度（SD 1.8A度）。aSyenTRAx在这3组中也是如此（p < 0.02）。总体冠状面对线与股骨远端的旋转几何形状之间存在明确的线性关系。从内翻到外翻，每增加1A度，后髁角（PCL vs sTEA）增加0.1A度，在骨关节炎膝关节中，PCL相对于sTEA平均内旋1.6A度。PCL和sTEA之间的关系在不同冠状面对准组中有统计学差异。
There is a lot of inter-individual variation in the rotational anatomy of the distal femur. This study was set up to define the rotational anatomy of the distal femur in the osteo-arthritic knee and to investigate its relationship with the overall coronal alignment and gender.CT-scans of 231 patients with end-stage knee osteo-arthritis prior to TKA surgery were obtained. This represents the biggest series published on rational geometry of the distal femur in literature so far.The posterior condylar line (PCL) was on average 1.6A degrees (SD 1.9) internally rotated relative to the surgical transepicondylar axis (sTEA). The perpendicular to trochlear anteroposterior axis (aSyenTRAx) was on average 4.8A degrees (SD 3.3A degrees) externally rotated relative to the sTEA. The relationship between the PCL and the sTEA was statistically different in the different coronal alignment groups (p < 0.001): 1.0A degrees (SD 1.8A degrees) in varus knees, 2.1A degrees (SD 1.8A degrees) in neutral knees and 2.6A degrees (SD 1.8A degrees) in valgus knees. The same was true for the aSyenTRAx in these 3 groups (p < 0.02).There was a clear linear relationship between the overall coronal alignment and the rotational geometry of the distal femur. For every 1A degrees in coronal alignment increment from varus to valgus, there is a 0.1A degrees increment in posterior condylar angle (PCL vs sTEA).The PCL was on average 1.6A degrees internally rotated relative to the sTEA in the osteo-arthritic knee. The relationship between the PCL and the sTEA was statistically different in the different coronal alignment groups.III.