需要可变的轴旋转才能在全膝关节整形术中实现平衡的曲间隙
Jessica M Hooper1, Kevin A Lawson1, Derek F Amanatullah1
1Department of Orthopaedic Surgery, Stanford University School of Medicine Redwood City, California.
Journal of surgical orthopaedic advances
|December 11, 2025
概括
在全膝关节置换中,大腿骨旋转有很大的差异,没有一个位置可以平衡所有膝关节的曲间隙. 在手术期间调整轮转是获得最佳结果的关键.
科学领域:
- 整形外科手术 整形外科手术
- 生物机械工程 生物机械工程
- 医疗成像医学成像
背景情况:
- 全膝关节置换 (TKR) 旨在恢复功能并缓解疼痛.
- 股骨部件的旋转对于平衡的膝盖动力学和屈曲间隙稳定性至关重要.
- 目前的技术往往依赖于预先确定的旋转对齐,可能导致失衡.
研究的目的:
- 用修改的间隙平衡技术量化后部稳定TKR的轴平面上的股骨旋转.
- 为了研究手术前冠状元对准对大腿部部件旋转的影响.
- 为了评估不同膝关节对齐组的股骨轴旋转的可变性.
主要方法:
- 从计算机辅助整形外科手术 (CAOS) 导航系统数据库中分析了2442个后部稳定的TKR病例.
- 根据手术前的冠状元对齐,将膝盖分为瓦鲁斯,中性和瓦尔古斯群的分层.
- 通过CAOS导航记录远端股骨和骨切除角度以及股骨部件的旋转位置.
主要成果:
- 在所有对齐组中观察到股骨轴旋转的实质性变化.
- 整体平均股骨旋转为2.4°外侧.
- 平均旋转为2.5°外侧的,2.5°外侧的中立,和1.1°外侧的膝盖 (p < 0.0001).
结论:
- 与手术内调整相比,预先确定的股骨部件旋转可能会增加曲间隙不对称性.
- 在Varus和Valgus膝盖之间的平均股骨部件旋转存在统计学上显著的差异.
- 在手术期间优化股骨旋转对于在TKR中实现平衡的曲间隙至关重要.
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