【摘要】 目的对正常及内翻畸形骨性关节炎膝关节行MRI测量,探讨股骨远端旋转对线的变化以指导临床。方法 MRI扫描60侧正常膝关节(A组)、40侧轻度(B组)及20侧重度(C组)内翻畸形骨性关节炎膝关节,MRI上定位STEA、CTEA、PCL、WL、AFA为骨性标志物,测量并比较3组CSA、PCA、CTA、WSA、WCA、AFSA、AFCA。结果 3组间CSA、WSA、WCA、AFSA、AFCA比较差异无统计学意义(P>0.05)。A组与B组、B组与C组的PCA、CTA比较差异无统计学意义(P>0.05),但A组与C组的PCA、CTA比较差异有统计学意义(P<0.05)。结论重度内翻畸形骨性关节炎影响股骨PCA及CTA,两者在C组有所减小;WSA、WCA不受骨性关节炎的影响,但角度变异较大,不能只用WL决定股骨假体的旋转;AFSA、AFCA不受骨性关节炎的影响,两者变异小(标准差为2.18°及2.38°),参照该轴放置股骨假体较可靠。更多还原

【Abstract】 Objective To measure the distal femoral rotational alignments on the normal and osteoarthritis knees,and explore the changes in the three groups for guiding clinical work and reducing the postoperative complications.Methods Sixty normal knees(group A),40 osteoarthritis knees of mild varus deformity(group B) and 20 osteoarthritis knees of severe varus deformity(group C) were scanned by MRI,STEA,CTEA,PCL,WL,AFA were located,then CSA,PCA,CTA,WSA,WCA,AFSA,AFCA were measured,and these angles were compared between 3 groups.Results There were no statistical differences in the 3 groups in CSA,WSA,WCA,AFSA and AFCA(P >0.05).PCA and CTA had no statistical differences between group A and group B,no statistical differences between group B and group C(P >0.05),but there were statistical differences between group A and group C(P <0.05).Conclusion When the osteoarthritis knee has severe varus deformity,the PCA and CTA will be reduced.WSA and WCA are not affected by osteoarthritis,however the variation of values suggests that the Whiteside line should not be used alone as a rotational assessment guide.TSA and TCA are not affected by osteoarthritis,and the SD of 2.18 ° and 2.38° respectively shows that the AFA is a stable axis.更多还原