Importance of the lateral anatomic tibial slope as a guide to the tibial cut in total knee arthroplasty in Japanese patients
Importance of the lateral anatomic tibial slope as a guide to the tibial cut in total knee arthroplasty in Japanese patients
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DOI：
10.1007/s00776-004-0855-7
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发表时间：
2005-01-01
影响因子：
1.7
通讯作者：
Iwamoto, Y
中科院分区：
文献类型：
--
作者：
Kuwano, T;Urabe, K;Iwamoto, Y
利用三维计算机断层扫描在50个骨关节炎的膝盖，我们模拟在不同的切割角度胫骨全膝关节置换术。使用0 °、3 °、5 °、7 °、9 °和11 °的切割角度。然后，我们计算了在每个切割角度下切除胫骨的前后厚度、内外宽度以及内外髁深度。根据截骨角度和解剖后倾角之间的比较，对每组测量值进行评价。内、外侧平台前后差异最小的切割角度分别为90 °和70 °。内、外侧平台的平均解剖后倾角分别为9.0 °和8.1 °。以最接近内侧解剖后坡的角度截骨时，12个膝关节（24%）切除的外侧后平台厚度> 10mm。12个膝关节中，9个膝关节（75%）的截骨角大于90 °。相比之下，当以最接近外侧解剖后斜面的切割角度切割胫骨时，仅一个切除的内侧后平台大于10 mm。该病例的切割角度为7 °。因此，考虑到从解剖后斜面截骨的厚度，我们证明了使用外侧解剖胫骨后斜面作为胫骨截骨指南的重要性。在任何切割角度下，切除骨形态均无显著差异。
Using three-dimensional computed tomography in 50 osteoarthritic knees, we simulated at various cutting angles the tibial cut for total knee arthroplasty. Cutting angles of 0degrees, 3degrees, 5degrees, 7degrees, 9degrees, and 11degrees were used. We then calculated the anterior and posterior thicknesses, the medial-lateral widths, and the medial and lateral condylar depths of the resected tibial bone at each cutting angle. Each set of measurements was evaluated according to a comparison between the cutting angle and the anatomic posterior slopes. The cutting angles showing the smallest anterior-posterior difference at the medial and lateral plateaus were 9degrees and 7degrees, respectively. The mean anatomic posterior slopes at the medial and lateral plateaus were 9.0degrees and 8.1degrees, respectively. When the tibia was cut at the cutting angle closest to the medial anatomical posterior slope in each knee, the thickness of the lateral posterior plateaus resected from 12 knees (24%) was more than 10mm. Among these 12 knees, the cutting angle was more than 9degrees in 9 knees (75%). In contrast, when the tibia was cut at the cutting angle closest to the lateral anatomical posterior slope, only one resected medial posterior plateau was more than 10mm. The cutting angle of this case was 7degrees. Therefore, in consideration of the thickness of bone resection from anatomic posterior slope, we demonstrated the importance of using the lateral anatomic posterior tibial slope as a guide to the tibial cut. There was no significant difference with respect to resected bone morphology at any cutting angle.