Zhao Bao-hui, Chen Bai-cheng, Shao De-cheng, Wang Fei, Gao Shi-jun, Lu Bo
Department of Joint Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, China.
Zhonghua Wai Ke Za Zhi. 2008 Jul 15;46(14):1085-7.
To investigate the relationships among rotational alignment reference axes of distal femur and tibial mechanical axis, and determine the safest rotational alignment reference axis.
Digital photos were taken of 30 cadaveric lower extremities with knee in extension and flexion at 90 degrees , angles were measured among tibial mechanical axis and a line perpendicular to clinical epicondylar axis, a line perpendicular to surgical epicondylar axis, Whiteside's line and femoral mechanical axis. Statistical analysis of relationships among those axes were performed.
The angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, a line perpendicular to the surgical epicondylar axis, Whiteside's line and femoral mechanical axis were 0.6 degrees varus, 3.9 degrees varus, 0.2 degrees valgus and 3.0 degrees varus respectively. The angle between the femoral mechanical axis and the tibial mechanical axis was significantly larger than the angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, the Whiteside's line (P < 0.05). There was no significant difference compared with the angle between a line perpendicular to the surgical epicondylar axis and the tibial mechanical axis. Angles of the clinical epicondylar axis, the surgical epicondylar axis and the Whiteside's line between knee extension and flexion were 2.3 degrees valgus, 0.9 degrees varus and 3.1 degrees valgus respectively.
The surgical epicondylar axis rather than the clinical epicondylar axis or the Whiteside's line is the safest femoral rotational alignment reference axis intraoperatively.
探讨股骨远端旋转对线参考轴与胫骨机械轴之间的关系，并确定最安全的旋转对线参考轴。
对30具尸体下肢在膝关节伸直和屈曲90度时拍摄数码照片，测量胫骨机械轴与垂直于临床髁上轴的线、垂直于手术髁上轴的线、Whiteside线和股骨机械轴之间的角度。对这些轴之间的关系进行统计分析。
胫骨机械轴与垂直于临床髁上轴的线、垂直于手术髁上轴的线、Whiteside线和股骨机械轴之间的角度分别为内翻0.6度、内翻3.9度、外翻0.2度和内翻3.0度。股骨机械轴与胫骨机械轴之间的角度明显大于胫骨机械轴与垂直于临床髁上轴的线、Whiteside线之间的角度（P<0.05）。与垂直于手术髁上轴的线和胫骨机械轴之间的角度相比，差异无统计学意义。临床髁上轴、手术髁上轴和Whiteside线在膝关节伸直和屈曲之间的角度分别为外翻2.3度、内翻0.9度和外翻3.1度。
手术髁上轴而非临床髁上轴或Whiteside线是术中最安全的股骨旋转对线参考轴。
