Goebel M, Burgkart R, Gerdesmeyer L, Diehl P, Schmitt-Sody M, Plötz W, Gradinger R
Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München.
Orthopade. 2005 Nov;34(11):1150-2, 1154-9. doi: 10.1007/s00132-005-0857-y.
Arthrotic deformities with changes in knee geometry can produce difficulties in implanting long stem knee prosthesis systems using intramedullary alignment. They can result in incorrect lower limb axis and prosthesis positioning. The aim of the presented study was to measure knee geometry in patients with varus and valgus gonarthrosis in order to define diagnosis related differences.
A total of 75 patients with indication for total knee arthroplasty were divided in two groups using the weight bearing lower limb axis: patients with varus gonarthrosis (n=43) and with valgus gonarthrosis (n=32). Angles and extensions, important for knee prosthesis implantation, were measured, digitalized and analyzed. The results were investigated for diagnosis specific differences.
After regulation of the measured extension in mean femur/tibia lengths, significant diagnosis specific differences were found: femur condyles were widened towards pathologic weight bearing (P<0.044), and the mechanical tibia axis of the varus gonarthrosis group is transferred to the lateral side (P<0.046) and in projection over the lateral internal cortical substance.
The significant differences in deformed arthrotic knees indicate that for an optimal postoperative result the use of standard implants is not always sufficient. Modular knee prosthesis systems can provide adequately for individual demands.
膝关节几何形状改变导致的关节畸形会给使用髓内对线植入长柄膝关节假体系统带来困难。这可能导致下肢轴线和假体定位不正确。本研究的目的是测量内翻和外翻膝骨关节炎患者的膝关节几何形状，以确定与诊断相关的差异。
根据负重下肢轴线将75例有全膝关节置换指征的患者分为两组：内翻膝骨关节炎患者（n = 43）和外翻膝骨关节炎患者（n = 32）。测量、数字化并分析对膝关节假体植入重要的角度和伸展度。研究结果以确定诊断特异性差异。
在平均股骨/胫骨长度的测量伸展度调整后，发现了显著的诊断特异性差异：股骨髁向病理负重方向增宽（P < 0.044），内翻膝骨关节炎组的机械胫骨轴线向外侧移位（P < 0.046），并投影在外侧皮质骨上。
关节畸形膝关节的显著差异表明，为了获得最佳术后效果，仅使用标准植入物并不总是足够的。模块化膝关节假体系统可以充分满足个体需求。
