Jeffery R S, Morris R W, Denham R A
Department of Orthopaedics, Queen Alexandra Hospital, Portsmouth, Hampshire, England.
J Bone Joint Surg Br. 1991 Sep;73(5):709-14. doi: 10.1302/0301-620X.73B5.1894655.
Maquet's line passes from the centre of the femoral head to the centre of the body of the talus. The distance of this line from the centre of the knee on a long-leg radiograph provides the most accurate measure of coronal alignment. Malalignment causes abnormal forces which may lead to loosening after knee replacement. We report a series of 115 Denham knee replacements performed between 1976 and 1981 using the earliest design of components, inserted with intramedullary guide rods. Patients were assessed clinically and long-leg standing radiographs were taken before operation, soon after surgery and up to 12 years later. In two-thirds of the knees (68%) Maquet's line passed through the middle third of the prosthesis on postoperative films and the incidence of subsequent loosening was 3%. When Maquet's line was medial or lateral to this, an error of approximately +/- 3 degrees, the incidence of loosening at a median period of eight years was 24%. This difference is highly significant (p = 0.001). Accurate coronal alignment appears to be an important factor in prevention of loosening. Means of improving the accuracy of alignment and of measuring it on long-leg radiographs are discussed.
马凯线从股骨头中心延伸至距骨体中心。在长腿X线片上，这条线与膝关节中心的距离提供了最准确的冠状位对线测量值。对线不良会产生异常应力，这可能导致膝关节置换术后假体松动。我们报告了1976年至1981年间使用最早设计的组件并通过髓内导杆植入进行的115例丹纳姆膝关节置换手术。对患者进行了临床评估，并在术前、术后不久以及术后长达12年拍摄了长腿站立位X线片。在三分之二（68%）的膝关节中，术后X线片上马凯线穿过假体的中三分之一，随后假体松动的发生率为3%。当马凯线位于此范围内侧或外侧，即大约±3度的误差时，在中位八年的时间里假体松动的发生率为24%。这种差异具有高度统计学意义（p = 0.001）。准确的冠状位对线似乎是预防假体松动的一个重要因素。文中讨论了提高对线准确性以及在长腿X线片上进行测量的方法。
