Barink M, van de Groes S, Verdonschot N, de Waal Malefijt M
Orthopaedic Research Laboratory, University Medical Center Nijmegen, Nijmegen, The Netherlands.
Clin Orthop Relat Res. 2003 Jun(411):288-95. doi: 10.1097/01.blo.0000069892.31220.26.
Malfunctioning of total knee replacements often is related to patellofemoral problems. Because the trochlea guides the patella during flexion and extension, its geometry has a major influence in patellofemoral problems. There is controversy in the literature: relative to the mechanical axis, some authors have found a laterally oriented trochlea and others have found a medially oriented trochlea. The groove of implanted prosthetic femoral components always has lateral or neutral orientations. The objectives of the current study were to clarify the controversy found in the literature, to determine whether the trochlear orientation is truly linear, and to determine whether the orientation depends on the size of the femur. The trochleae of 100 human femurs were measured using a three-dimensional measurement system. Detailed analysis of the results indicated that the trochlea is best described as bilinear, with the distal half oriented 0.2 degrees +/- 2.8 degrees laterally and the proximal half oriented 4.2 degrees +/- 3.2 degrees medially. Trochlear orientation was not dependent on bone size.
全膝关节置换术的故障常常与髌股问题有关。由于在屈伸过程中滑车引导髌骨，其几何形状在髌股问题中具有重大影响。文献中存在争议：相对于机械轴，一些作者发现滑车向外侧定向，而另一些作者发现滑车向内侧定向。植入的人工股骨部件的凹槽总是具有外侧或中立的定向。本研究的目的是澄清文献中发现的争议，确定滑车定向是否真的是线性的，并确定该定向是否取决于股骨的大小。使用三维测量系统测量了100例人类股骨的滑车。对结果的详细分析表明，滑车最好描述为双线性，远端一半向外侧定向0.2度±2.8度，近端一半向内侧定向4.2度±3.2度。滑车定向不取决于骨骼大小。
