【摘要】 目的测量在的站立位下肢全长X片中人工全膝关节置换术(total knee arthroplasty,TKA后早中期胫骨平台假体周围的骨小梁方向,分析其变化规律和机制。方法回顾性分析2012年6月至2016年5月于我院进行TKA治疗的病例126例,收集病例术后、术后3个月、术后1、3、5年的固定旋转方向站立正位下肢全长X光照片,在所得照片上测量胫骨平台内外侧骨小梁角度、术后下肢力线、胫骨假体力,收集患者年龄、性别、BMI,并进行统计分析。结果病例胫骨平台内侧假体周围骨小梁角度于术后3个月平均减小了5.3°±2.65°,至术后1年平均减小8.3°±3.03°,外侧骨小梁角度于术后3个月平均减小了4.5°±1.71°,至术后1年平均减小7.6°±2.43°,1年后至术后3年、5年并无显著变化。术后下肢力线与胫骨平台内外侧骨小梁角度之间于术后1、3、5年均呈现出弱至中等程度的相关性。结论 TKA术后下肢力线的纠正导致了胫骨平台骨小梁方向的改变,术后1年内胫骨平台骨小梁整体向垂直于胫骨假体平台的方向重构。更多还原

【Abstract】 Objective Measuring the trabecular orientation in the periprosthetic tibial platform in early and mid-term rotation-fixed weigh bearing full leg X-rays of patients underwent total knee arthroplasty(TKA)and analysis of the pattern and mechanism of the trabecular realignment. Methods A retrospective analysis was conducted on the 126 cases underwent TKA in our institutione from June,2012 to May,2016. Rotation-fixed weigh bearing full leg X-rays taken at after surgery,3 months,1 year,3 years and 5 years follow-up were obtained. Trabecular orientation in the medial and lateral periprosthetic tibial platform were measured on the X-rays.Age,sex,BMI of patients were obtained and analyzed. Results The trabecular orientation around the medial prosthetic tibial platform decreased by an average of 5.3° ± 2.65° at 3 months and 8.3° ± 3.03° at 1 year after operation. The trabecular orientation around the lateral prosthetic tibial platform decreased by an average of 4.5° ±1.71° at 3 months and 7.6° ± 2.43° at 1 year after operation. No significant changes from 1 year to 3 and 5 years after operation were observed. There was a weak to moderate correlation between the postoperative mechanical axis and the trabecular orientation in the medial and lateral prosthetic tibial platform at 1,3 and 5 years after operation.Conclusions Trabecular orientation in the tibia platform realigned due to the correction of the mechanical axis after TKA. Trabeculae in the periprosthetic tibial platform reconstructed within 1 year after TKA,tending to be perpendicular to the tibial plateau.更多还原