Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery.
Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery.
复制标题
膝关节屈曲过程中股骨髁高度变化的研究：对 TKA 手术间隙平衡的影响。
DOI：
10.1007/s00402-021-04155-w
复制
发表时间：
2022
影响因子：
2.3
通讯作者：
Li,Guoan
中科院分区：
文献类型：
--
作者：
Zhang,Zhenming;Zhou,Chaochao;Rao,Zhitao;Foster,Timothy;Bedair,Hany;Li,Guoan
研究背景在全膝关节置换术（TKA）中，以经上髁轴（TEA）为参考，对膝关节屈曲0°和90°时的间隙平衡进行了研究。本研究调查的tibiofemoral关节的高度变化和股骨髁的高度变化测量使用不同的flexion axis.Materials和methodsTwenty健康膝关节的数据进行了比较，在体内负重屈曲使用的技术相结合的MRI和双透视成像系统（DFIS）。在每个屈曲角度下确定胫股接触点和股骨髁高度[使用：TEA、几何中心轴（GCA）和等高度轴（IHA）测量]。结果膝关节内、外侧接触点高度沿着屈曲路径的变化均在2.5mm以内，内、外侧髁高度变化分别在TEA的8.9mm以内、GCA的4.2mm以内、IHA的3.0mm以内。接触点法和IHA法测量的高度变化相似（p> 0.05），且均显著小于TEA法和GCA法（p< 0.05）。结论TEA法和GCA法测量的股骨髁高度不同，而IHA法测量的髁高度变化最小，能更好地反映膝关节的关节特性。数据表明，IHA可用作替代参考，以指导TKA手术期间沿膝关节屈曲路径沿着间隙平衡的手术准备。
BackgroundGap balance of the knee at 0° and 90° of flexion has been pursued in total knee arthroplasty (TKA) with the trans-epicondyle axis (TEA) as a reference. This study investigated the height changes of the tibiofemoral articulation and compared the data with the femoral condyle height changes measured using different flexion axes.Materials and methodsTwenty healthy knees were investigated during an in vivo weightbearing flexion using a technique combining MRI and a dual fluoroscopic imaging system (DFIS). The tibiofemoral contact points and the femoral condyle heights [measured using: TEA, geometric center axis (GCA), and iso-height axis (IHA)] were determined at each flexion angle. The height changes of the articular contact points and the femoral condyles were compared along the flexion path.ResultsThe changes of the medial and lateral contact point heights were within 2.5 mm along the flexion path. The changes of the medial and lateral condyle heights were within 8.9 mm for TEA, within 4.2 mm for GCA and within 3.0 mm for IHA. The height changes measured by the contact points and IHA are similar (p> 0.05), and both are significantly smaller than those measured using the TEA and GCA (p< 0.05).ConclusionsThe TEA and GCA measured varying femoral condyle heights, but the IHA resulted in minimal condyle height changes and could better represent the articulation characteristics of the knee. The data suggested that the IHA could be used as an alternative reference to guide surgical preparation of gap balance along the knee flexion path during TKA surgeries.