Department of Orthopedic, Zhongshan Hospital, Fudan University, No. 180, Rd. Fenglin, Shanghai, China.
Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2580-2586. doi: 10.1007/s00167-016-4386-5. Epub 2016 Nov 28.
To investigate the orientations of the surgical epicondylar axis (SEA) of varus and non-varus knees in the coronal plane.
One-hundred and sixty-two knees from 81 Chinese patients undergoing total knee arthroplasty (TKA) were retrospectively investigated. The angle between the medial side of the femoral mechanical axis and the SEA (MA-SEA), as well as the physiological valgus angle, was measured in the coronal plane using three-dimensional reconstruction. The joint line angle (JLA) and hip-knee-ankle angle (HKAA) were measured in long-leg weight-bearing radiographs. The mean of each parameter was compared between the varus (HKAA < 177.0°) and the non-varus knees (HKAA ≥ 177.0°) using an independent t test. Linear regression was used to assess the correlation between MA-SEA with JLA and HKAA.
A total of 42 non-varus knees (6 valgus and 36 neutral knees) and 98 varus knees were measured, as 22 knees were abandoned due to unrecognizable bony landmarks. The mean MA-SEA and JLA were significantly larger in non-varus knees (both, p < 0.01). The mean physiological valgus angle was 5.9 ± 1.0° for Chinese TKA patients and was significantly larger in varus knees (p < 0.01). There was a strong positive correlation between the MA-SEA and JLA (R = 0.35, p < 0.05).
There were significant differences in the orientation of the SEA between varus and non-varus knees, which was strongly correlated with the orientation of the femoral joint line. These findings will enhance the current knowledge of knee anatomy and should prove useful for coronal alignment in TKA.
III.
研究冠状面内外翻膝关节的外科上髁轴（SEA）方向。
回顾性分析 81 例在中国行全膝关节置换术（TKA）的患者的 162 膝。使用三维重建测量冠状面股骨机械轴内侧与 SEA（MA-SEA）之间的夹角以及生理性外翻角。在下肢全长负重位 X 线片上测量关节线角（JLA）和髋膝踝角（HKAA）。采用独立 t 检验比较 HKAA＜177.0°的外翻膝和 HKAA≥177.0°的非外翻膝之间各参数的平均值。采用线性回归评估 MA-SEA 与 JLA 和 HKAA 的相关性。
共测量了 42 例非外翻膝（6 例外翻和 36 例中立膝）和 98 例外翻膝，由于无法识别骨性标志，有 22 例膝被放弃。非外翻膝的 MA-SEA 和 JLA 平均值明显较大（均，p＜0.01）。中国 TKA 患者的生理性外翻角平均值为 5.9°±1.0°，外翻膝明显较大（p＜0.01）。MA-SEA 与 JLA 之间存在很强的正相关（R=0.35，p＜0.05）。
外翻膝和非外翻膝的 SEA 方向存在显著差异，与股骨关节线的方向密切相关。这些发现将增强对膝关节解剖结构的现有认识，并有助于 TKA 的冠状面对线。
III 级。
