Mutsuzaki Hirotaka, Ikeda Kotaro
Department of Orthopaedic Surgery, Ichihara Hospital, 3681 Ozone, Tsukuba, Ibaraki, 300-3295, Japan.
Sports Med Arthrosc Rehabil Ther Technol. 2012 Nov 15;4(1):44. doi: 10.1186/1758-2555-4-44.
Achieving precise implant alignment is crucial for producing good outcomes after total knee arthroplasty (TKA). We introduce a simple method for confirming the accuracy of tibial osteotomy during TKA.
Two metallic markers were placed on the skin 20 cm apart, one on the tibial tuberosity and other on the tibial crest, points that are easily identified and palpated intraoperatively. Anteroposterior radiographs of the legs were obtained. We defined the line along the markers as the tuberosity line. The osteotomy line is perpendicular to the anatomical axis of the tibia. We then calculated the angle between these two lines and designated it the osteotomy angle. We set the osteotomy angle of the protractor, and cut the bone parallel to the osteotomy line of the protractor. Postoperatively, we analyzed the varus angle of the tibial osteotomy in 35 TKAs using the protractor. The average of the varus angle of the tibial osteotomy was 89.4° ± 1.6° (95% confidence interval of -1.0976, 0.0119). There was no significant difference from the target angle of 90° (p = 0.055). The varus angles of 90° and 90° ± 2° for the tibial osteotomy were 42.9% and 82.9%, respectively.
We determined the accuracy of the tibial osteotomy in the coronal plane using the protractor to be satisfactory.
在全膝关节置换术（TKA）后获得精确的植入物对线对于取得良好疗效至关重要。我们介绍一种在TKA期间确认胫骨截骨准确性的简单方法。
在皮肤上相距20 cm放置两个金属标记物，一个位于胫骨结节，另一个位于胫骨嵴，这些点在术中易于识别和触摸。获取双腿的前后位X线片。我们将沿着标记物的线定义为结节线。截骨线垂直于胫骨的解剖轴。然后我们计算这两条线之间的角度并将其指定为截骨角度。我们设置量角器的截骨角度，并平行于量角器的截骨线切割骨头。术后，我们使用量角器分析了35例TKA中胫骨截骨的内翻角度。胫骨截骨内翻角度的平均值为89.4°±1.6°（95%置信区间为-1.0976, 0.0119）。与目标角度90°无显著差异（p = 0.055）。胫骨截骨90°和90°±2°的内翻角度分别为42.9%和82.9%。
我们确定使用量角器在冠状面评估胫骨截骨的准确性是令人满意的。
