Morishita M
Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Kanagawa, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1989 Sep;63(9):1047-59.
Alignment of the lower extremities in secondary coxarthrosis (273 lower extremities) and controls (240 normal lower extremities) were studied using roentogenograms of whole lower extremities including the pelvis taken in the standing position with both legs. Secondary coxarthrosis, which is caused by congenital dislocation of the hip joint, was classified into four groups: unreduced dislocation, high dislocation, incomplete dislocation, and dysplasia of the acetabulum. Comparative studies were conducted using statistical data on measured items, obtained from secondary coxarthrosis cases and controls. In controls, the femoro-tibial angle (FTA) was 175.5 +/- 2.08 degrees and the mechanical axis passed through the medial side to the middle of the knee. It has been noted that a tendency for bow-legs was seen after the age of 50. In coxarthrosis with high dislocation, the most marked knock-knees were observed (FTA of 172.5 +/- 3.88 degrees), while in coxarthrosis with incomplete dislocation and dysplasia of the acetabulum, there was a tendency to coxa valga but no tendency toward knock-knees was evident. Cases of total hip replacement revealed that it is possible to improve knock-knees by installing a socket in the primary acetabulum as much as possible, correcting the difference between the length of the legs and elimating adduction contracture. It was also possible to study factors contributing to bow-legs and knock-knees by means of multivariate analysis.
利用包括骨盆在内的整个下肢的站立位双腿X线片，对继发性髋关节病（273条下肢）和对照组（240条正常下肢）的下肢对线情况进行了研究。由先天性髋关节脱位引起的继发性髋关节病分为四组：未复位脱位、高位脱位、不完全脱位和髋臼发育不良。使用从继发性髋关节病病例和对照组获得的测量项目统计数据进行了比较研究。在对照组中，股胫角（FTA）为175.5±2.08度，机械轴从内侧穿过膝关节中部。有人指出，50岁以后出现了膝内翻的趋势。在高位脱位的髋关节病中，观察到最明显的膝外翻（FTA为172.5±3.88度），而在髋臼不完全脱位和发育不良的髋关节病中，有髋外翻的趋势，但没有明显的膝外翻趋势。全髋关节置换病例显示，通过尽可能在原髋臼处安装髋臼杯、纠正双腿长度差异和消除内收挛缩，可以改善膝外翻。通过多变量分析也有可能研究导致膝内翻和膝外翻的因素。
