Mayo Clinic, Department of Orthopedic Surgery, 200 First Street SW, Rochester, Minnesota 55905, USA.
University College London Hospital, Department of Trauma and Orthopaedics, 235 Euston Road, London NW1 2BU, UK.
Bone Joint J. 2014 Jul;96-B(7):857-62. doi: 10.1302/0301-620X.96B7.33946.
Substantial healthcare resources have been devoted to computer navigation and patient-specific instrumentation systems that improve the reproducibility with which neutral mechanical alignment can be achieved following total knee replacement (TKR). This choice of alignment is based on the long-held tenet that the alignment of the limb post-operatively should be within 3° of a neutral mechanical axis. Several recent studies have demonstrated no significant difference in survivorship when comparing well aligned versus malaligned TKRs. Our aim was to review the anatomical alignment of the knee, the historical and contemporary data on a neutral mechanical axis in TKR, and the feasibility of kinematically-aligned TKRs. Review of the literature suggests that a neutral mechanical axis remains the optimal guide to alignment.
大量的医疗资源被投入到计算机导航和患者特异性器械系统中，这些系统提高了全膝关节置换（TKR）后实现中性机械对线的可重复性。这种对线方式的选择基于一个长期以来的原则，即术后肢体的对线应在中性机械轴的 3°以内。最近的几项研究表明，在比较对线良好与对线不良的 TKR 时，生存率没有显著差异。我们的目的是回顾膝关节的解剖对线、TKR 中中性机械轴的历史和当代数据，以及运动学对线 TKR 的可行性。文献回顾表明，中性机械轴仍然是对线的最佳指南。
