Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan,
Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):2947-53. doi: 10.1007/s00167-014-2867-y. Epub 2014 Feb 2.
Various rotational landmarks including the surgical epicondylar axis (SEA) are used for preoperative planning and intra-operative reference of total knee arthroplasty (TKA) in the axial plane. The aim of the study was to elucidate the relationships between the SEA and other femoral anatomical landmarks, including the mechanical axis, distal and posterior knee joints, the trochlear groove, and the anterior femoral condyle, in both the coronal and axial planes.
Angular and linear measurements were taken of sixty femora using Orthomap3D, which has a tool to analyse computed tomography image data that makes it possible to measure three-dimensional distances and angles precisely. The inter- and intra-observer reliabilities of these measurements were evaluated. Comparisons were made according to height, weight, body mass index, and gender.
The angle between the mechanical axis and the SEA was 90.2° (95% CI 90.0°-90.4°). There was a significant correlation for each linear measurement between the SEA and the distal/posterior knee joint line and for each linear measurement between the SEA and the anterior medial/lateral femoral condyle. A significant difference was observed between genders in the linear measurements. Significant correlations were found between height and weight and linear parameters.
Knowledge of the relationships between the SEA and other femoral anatomical landmarks is useful in preoperative planning, intra-operative landmark, and postoperative assessment of TKA. The SEA is a consistent parameter of femoral alignment in the coronal plane and a stable reference for femoral rotation in the axial plane.
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在矢状面中，各种旋转标志点（包括外科髁上轴（SEA））被用于全膝关节置换术（TKA）的术前规划和术中参考。本研究的目的是阐明 SEA 与其他股骨解剖标志点（包括机械轴、膝关节远侧和后侧、滑车沟和股骨前髁）在冠状面和矢状面中的关系。
使用 Orthomap3D 对 60 个股骨进行了角度和线性测量，该软件具有分析 CT 图像数据的工具，可精确测量三维距离和角度。评估了这些测量的组内和组间可靠性。根据身高、体重、体重指数和性别进行了比较。
机械轴和 SEA 之间的角度为 90.2°（95%置信区间 90.0°-90.4°）。SEA 与膝关节远侧/后侧线之间的每个线性测量以及 SEA 与股骨前内侧/外侧髁之间的每个线性测量之间均存在显著相关性。线性测量在性别之间存在显著差异。身高和体重与线性参数之间存在显著相关性。
了解 SEA 与其他股骨解剖标志点之间的关系有助于 TKA 的术前规划、术中标志点和术后评估。SEA 是股骨在冠状面排列的一致性参数，是股骨在矢状面旋转的稳定参考。
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