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晚期膝关节骨关节炎中三维机械轴的关节外位置:一个直立计算机断层扫描研究
Ryo Sasaki1, Kazuya Kaneda2, Yoshitake Yamada3
1Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Japanese journal of radiology
|July 13, 2023
概括
三维机械轴 (3D-MA) 在膝关节骨关节炎 (OA) 膝关节中随着病情的进展而向中后移动. 这种3D-MA转换与OA中的骨对齐和膝盖曲收缩相关.
科学领域:
- 整形外科 整形外科 整形外科
- 生物医学工程 生物医学工程
- 放射学 放射学是指放射学
背景情况:
- 机械轴 (MA) 是下肢对齐的一个关键指标.
- 在膝关节骨关节炎 (OA) 中确定三维机械轴 (3D-MA) 对于了解疾病进展和治疗计划至关重要.
- 之前的研究主要集中在下肢对齐的二维评估上.
研究的目的:
- 通过使用直立计算机断层扫描 (CT) 来研究骨关节炎 (OA) 的膝盖中的三维机械轴 (3D-MA).
- 为了评估3D-MA相对于膝关节高原在不同级别的Kellgren-Lawrence (KL) 膝关节OA的位置变化.
- 评估3D-MA与其他相关放射性参数之间的相关性.
主要方法:
- 分析了38名患者的66个OA膝盖的直立计算机断层扫描 (CT) 数据.
- 确定了三维机械轴 (3D-MA),并量化了它在高原上的位置.
- 进行了统计分析,以比较KL等级的3D-MA位置,并评估与股骨角和膝盖屈曲的相关性.
主要成果:
- 在KL-1 OA膝盖中,3D-MA位于小腿骨平原的稍微中间和后部.
- 随着KL等级 (KL-3和KL-4) 的增加,3D-MA表现出显著的中后转换,在严重的OA中变得超关节.
- 3D-MA的中侧位置与股骨角强烈相关 (CC = -0.85,p < 0.001),前后位置与膝盖曲相关 (CC = -0.93,p < 0.001).
结论:
- 随着膝关节OA的进展,3D-MA向中后部移动.
- 膝关节OA中的Varus对齐与3D-MA的中间翻译有关.
- 膝盖曲收缩导致3D-MA在OA的后部翻译.
- 这些发现提供了更精确的了解3D下肢对齐在膝盖OA.
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