Effect of individual distal femoral valgus resection in total knee arthroplasty for patients with valgus knee: A retrospective cohort study
Effect of individual distal femoral valgus resection in total knee arthroplasty for patients with valgus knee: A retrospective cohort study
复制标题
个体化股骨远端外翻切除术在膝外翻患者全膝关节置换术中的效果：一项回顾性队列研究
DOI：
10.1016/j.ijsu.2018.02.048
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发表时间：
2018
影响因子：
15.3
通讯作者：
Pei Fuxing
中科院分区：
文献类型：
--
作者：
Zhou Kai;Zhou Zongke;Shi Xiaojun;Shen Bin;Kang Pengde;Yang Jing;Pei Fuxing
背景正确的肢体对齐和植入物定位对于成功的全膝关节置换术 (TKA) 非常重要。股骨远端切除固定股骨外翻矫正角（VCA）与个体化股骨外翻矫正角（VCA）在膝外翻肢体对线恢复方面是否存在差异尚不清楚。方法采用固定4°VCA（固定组）63例（66膝），个体化VCA（个体组）55例（59膝）。比较两组的VCA、机械股胫骨（MFT）角、股骨假体角（α）和胫骨假体角（β）。结果两组术后MFT角差异有统计学意义（2.0°±1.2°与2.8°±1.6°，p<0.002）。单独组中共有 51 名患者 (77.3%) 术后对位偏差在 ±3° 以内，而固定组中有 32 名患者 (54.2%) 出现术后对位偏差 (p=0.006)。我们发现 II 级膝外翻畸形个体组的术后对位精度更高（1.8°±1.2° 与 2.8°±1.5°，p=0.00）。两组之间的α角偏差存在显着差异（1.7°±1.3°与2.5°±1.8°，p=0.00）。个体组术后股骨冠状假体对位偏差在±3°以内的患者数量高于对照组（87.8% vs 67.8%，p=0.006）。结论本放射学研究表明，个体化VCA用于远端股骨切除术可以实现更好的术后对位精度，并且冠状面内肢体和股骨假体错位的异常值更少。
BackgroundProper limb alignment and implant positioning are important for successful total knee arthroplasty (TKA). It remains unknown whether any differences exist in the restoration of limb alignment for valgus knees between fixed and individual femoral valgus correction angle (VCA) for distal femoral resection.MethodsA total of 63 patients (66 knees) had fixed 4° VCA (fixed group), and 55 patients (59 knees) had individual VCA (individual group). We compared the VCA, mechanical femorotibial (MFT) angle, femoral component angle (α), and tibial component angle (β) between the two groups.ResultsThere were statistically significant differences in postoperative MFT angle between the two groups (2.0° ± 1.2° versus 2.8° ± 1.6°,p< 0.002). A total of 51 (77.3%) patients in the individual group had postoperative alignment deviation within ±3° compared with that of 32 (54.2%) patients in the fixed group (p= 0.006). We found better postoperative alignment accuracies in the individual group for grade II knee valgus deformities (1.8° ± 1.2° versus 2.8° ± 1.5°,p= 0.00). There was a significant difference in α angle deviations between the two groups (1.7° ± 1.3° versus 2.5° ± 1.8°,p= 0.00). The number of patients with postoperative femoral coronal component alignment deviations within ±3° in the individual group was higher compared to that in the control group (87.8% versus 67.8%,p= 0.006).ConclusionsThis radiological study showed that individual VCA for distal femoral resection could achieve better postoperative alignment accuracy and fewer outliers of limb and femoral component malalignment in the coronal plane.