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正常膝关节与骨关节炎膝关节股骨髁的解剖学分析。

Anatomical analysis of the femoral condyle in normal and osteoarthritic knees.

作者信息

Matsuda Shuichi, Miura Hiromasa, Nagamine Ryuji, Mawatari Taro, Tokunaga Masami, Nabeyama Ryotaro, Iwamoto Yukihide

机构信息

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka City, Fukuoka 812-8582, Japan.

出版信息

J Orthop Res. 2004 Jan;22(1):104-9. doi: 10.1016/S0736-0266(03)00134-7.

Abstract

It is important to understand anatomical feature of the distal femoral condyle for treatment of osteoarthritic knees. Detailed measurement of the femoral condyle geometry, however, has not been available in osteoarthritic knees including valgus deformity. This study evaluated femoral condyle geometry in 30 normal knees, 30 osteoarthritic knees with varus deformity, and 30 osteoarthritic knees with valgus deformity using radiographs and magnetic resonance imaging (MRI). In radiographic analysis in the coronal plane, the femoral joint angle (lateral angle between the femoral anatomic axis and a tangent to femoral condyles) was 83.3 degrees in the normal knees, 83.8 degrees in the varus knees, and 80.7 degrees in the valgus knees. In MRI analysis in the axial plane, the posterior condylar tangent showed 6.4 degrees of internal rotation relative to the transepicondylar axis in the normal knees, 6.1 degrees in the varus knees, and 11.5 degrees in the valgus knees. These results suggested that there was no hypoplasia of the medial condyle in the varus knees, but the lateral condyle in the valgus knees was severely distorted. Surgeons should take this deformity of the lateral femoral condyle into account when total knee arthroplasty is performed for a valgus knee.

摘要

了解股骨远端髁的解剖特征对于治疗骨关节炎膝关节很重要。然而,在包括外翻畸形在内的骨关节炎膝关节中,尚未有对股骨髁几何形状的详细测量。本研究使用X线片和磁共振成像(MRI)评估了30个正常膝关节、30个内翻畸形骨关节炎膝关节和30个外翻畸形骨关节炎膝关节的股骨髁几何形状。在冠状面的X线片分析中,正常膝关节的股关节角(股骨解剖轴与股骨髁切线之间的外侧角)为83.3度,内翻膝关节为83.8度,外翻膝关节为80.7度。在轴面的MRI分析中,正常膝关节的后髁切线相对于经髁间轴有6.4度的内旋,内翻膝关节为6.1度,外翻膝关节为11.5度。这些结果表明,内翻膝关节的内侧髁没有发育不全,但外翻膝关节的外侧髁严重变形。在为外翻膝关节进行全膝关节置换时,外科医生应考虑到股骨外侧髁的这种畸形。

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