Gao Zhihui, Shi Xiaoqiang, Fang Xiaomin, Bao Liang, Jin Qunhua
The Third Department of Orthopedics, General Hospital of Ningxia Medical University, Yinchuan Ningxia 750004, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Oct;26(10):1174-7.
To investigate the impact of difference between the medial and lateral posterior condyle cartilage thickness on osteotomy in total knee arthroplasty (TKA) by measuring the thickness of the medial and lateral femur posterior condylar cartilage and the posterior condylar angle (PCA) in osteoarthritis (OA) patients.
Between May and December 2011, 53 OA patients (60 knees) scheduled for TKA met the inclusion criteria (OA group). There were 12 males (14 knees) and 41 females (46 knees), aged 57-82 years (mean, 71.9 years). The tibiofemoral angle was (183.2 +/- 2.6) degrees. Fifteen healthy volunteers (30 knees) were taken as controls (control group); there were 6 males and 9 females, aged 59-68 years (mean, 66.3 years). MRI scan data were imported into Mimics 10.01 medical image control system to measure the thickness of femur posterior condylar cartilage and the PCA with and without femur posterior condylar cartilage.
In the control group, the thickness of the medial and lateral femur posterior condylar cartilage was (1.85 +/- 0.33) mm and (1.92 +/- 0.27) mm respectively, the PCA with and without femur posterior condylar cartilage was (5.0 +/- 0.9) degrees and (5.1 +/- 0.8) degrees respectively, all showing no significant differences (P > 0.05). In OA group, the thickness of the medial and lateral femur posterior condylar medial cartilage was (0.45 +/- 0.40) mm and (1.78 +/- 0.51) mm respectively, the PCA with and without femur posterior condylar cartilage was (3.3 +/- 1.7) degrees and (4.8 +/- 1.8) degrees respectively, all showing significant differences (P < 0.05). In OA group, the difference between lateral and medial cartilage thickness was (1.33 +/- 0.45) mm, and the difference between PCA with and without femur posterior condylar cartilage was (1.5 +/- 1.3) degrees. There was a positive correlation between the difference of cartilage thickness and the difference of PCA (r = 0.75, P = 0.01).
There is significant difference between medial and lateral femur posterior condylar cartilage wear, which leads to difference of PCA. The difference will impact knee function and longevity of the prosthesis, so the difference should be considered during osteotomy.
通过测量骨关节炎（OA）患者股骨后髁内侧和外侧软骨厚度及后髁角（PCA），探讨全膝关节置换术（TKA）中后髁内侧和外侧软骨厚度差异对截骨的影响。
2011年5月至12月，53例行TKA的OA患者（60膝）符合纳入标准（OA组）。其中男性12例（14膝），女性41例（46膝），年龄57 - 82岁（平均71.9岁）。胫股角为（183.2±2.6）度。选取15名健康志愿者（30膝）作为对照组；其中男性6例，女性9例，年龄59 - 68岁（平均66.3岁）。将MRI扫描数据导入Mimics 10.01医学图像控制系统，测量有无股骨后髁软骨时的股骨后髁软骨厚度及PCA。
对照组中，股骨后髁内侧和外侧软骨厚度分别为（1.85±0.33）mm和（1.92±0.27）mm，有无股骨后髁软骨时的PCA分别为（5.0±0.9）度和（5.1±0.8）度，均无显著差异（P>0.05）。OA组中，股骨后髁内侧和外侧软骨厚度分别为（0.45±0.40）mm和（1.78±0.51）mm，有无股骨后髁软骨时的PCA分别为（3.3±1.7）度和（4.8±1.8）度，均有显著差异（P<0.05）。OA组中，外侧与内侧软骨厚度差为（1.33±0.45）mm，有无股骨后髁软骨时的PCA差值为（1.5±1.3）度。软骨厚度差异与PCA差值呈正相关（r = 0.75，P = 0.01）。
股骨后髁内侧和外侧软骨磨损存在显著差异，导致PCA不同。这种差异会影响膝关节功能及假体使用寿命，因此在截骨时应考虑这种差异。
