Moghtadaei Mehdi, Moghimi Javad, Shahhoseini Gholamreza
MD, Associate Professor of Orthopedics, Department of Orthopedic Surgery, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
MD, Orthopedic Surgeon, Department of Orthopedic Surgery, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2015 Jan 28;29:169. eCollection 2015.
Proper rotation of components in total knee arthroplasty (TKA) will largely affect the postoperative outcome. Ethnical variation may affect rotational profile. We aimed to evaluate distal femur rotation in Iranian population using transepicondylar axes.
From a total of 450 knee CT scans and via consecutive sampling, 150 qualified subjects with normal lower extremities alignment were selected comprising 96 (64%) males and 54 (36%) females aging 17-80 years. The posterior condylar angle and condylar twist angles were defined as angles between either surgical epicondylar axis (line connecting lateral epicondylar prominence and the medial sulcus) or clinical epicondylar axis (line connecting most prominent points of both epicondyle) and posterior conylar line. Data were compared among genders.
Average age of our samples was 43 years (ranging 11-80). Mean (±sd) values for posterior condylar angle and condylar twist angles were 2.35º (±1.34) and 5.77º (±1.70), respectively. The former variable was not discernible in twenty of our subjects because of obscure medial sulcus. Our findings were totally appeared similar to studies from other ethnicities and the observed minor differences may have originated from amount of osteoarthritis and malalignment.
Overall, Iranian distal femur rotational profile was similar to other reports. Some minor observed differences may be partially due to samples' age and different amount of knee osteoarthritis. It is proposed to rely on several methods for determining rotational profile while performing TKA. Moreover, preoperative computed tomography should be fully scrutinized especially in severely osteoarthitic knees.
全膝关节置换术（TKA）中组件的正确旋转在很大程度上会影响术后结果。种族差异可能会影响旋转特征。我们旨在使用经髁轴评估伊朗人群的股骨远端旋转情况。
从总共450例膝关节CT扫描中，通过连续抽样，选择了150例下肢对线正常的合格受试者，其中包括96例（64%）男性和54例（36%）女性，年龄在17 - 80岁之间。后髁角和髁扭转角定义为手术髁上轴（连接外侧髁突出点与内侧沟的线）或临床髁上轴（连接两侧髁最突出点的线）与后髁线之间的角度。对不同性别的数据进行了比较。
我们样本的平均年龄为43岁（范围为11 - 80岁）。后髁角和髁扭转角的平均值（±标准差）分别为2.35°（±1.34）和5.77°（±1.70）。由于内侧沟不清晰，在20名受试者中无法辨别前一个变量。我们的研究结果与其他种族的研究总体上相似，观察到的细微差异可能源于骨关节炎的程度和对线不良。
总体而言，伊朗股骨远端的旋转特征与其他报告相似。观察到的一些细微差异可能部分归因于样本的年龄和膝关节骨关节炎的不同程度。建议在进行全膝关节置换术时依靠多种方法来确定旋转特征。此外，术前计算机断层扫描应进行全面仔细检查，尤其是在严重骨关节炎的膝关节中。
