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膝盖冠状平面对齐 (CPAK) 现象类型分类的观察者间可靠性:使用骨关节炎倡议数据进行外部验证

William Wynell-Mayow¹, Thomas A G Hall², Abhinav Singh³

¹Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK.

Bone & joint open

|November 10, 2025

概括

使用放射图的膝盖冠状平面对齐 (CPAK) 分类显示了由于小角度测量错误而导致的重大错误分类率. 像CT这样的改进成像可能会提高全膝关节整形术规划的可靠性.

科学领域:

整形外科手术整形外科手术
放射学放射学是一门学科.
生物机械分析分析

背景情况:

膝盖冠状平面对齐 (CPAK) 现型定型对于了解全膝关节整形术 (TKA) 中的膝盖对齐至关重要.
CPAK的分类依赖于关节直线斜率 (JLO) 和算术-膝-脚角 (aHKA),由中间近接角 (MPTA) 和侧向远距离股骨角 (LDFA) 衍生出来.

研究的目的:

评估CPAK分类的可复制性.
为了确定与CPAK错误分类相关的角误差值.

主要方法:

两位读者分析了75张长腿X射线图 (LLRs),以检查读者之间的可重现性.
一位读者对1128个LLR进行了分类.
蒙特卡洛模拟评估了MPTA和LDFA测量变异性对CPAK一致性的影响.

主要成果:

发现MPTA (0.41°误差,ICC 0.96) 和LDFA (0.71°误差,ICC 0.91) 的可复制性非常好.
尽管单个角度的可重现性很高,但在CPAK分类中观察到20%的分歧率.
将CPAK的分歧降低到95%以下,将需要一个无法实现的aHKA误差小于0.1°.

结论:

从LLR中CPAK表型化可以导致临床上显著的错误分类率.
计算机断层扫描 (CT) 图像可能为CPAK分类提供更高的可靠性,特别是在临界角度值附近.

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