Liu Hwa-Chang, Wu Wen-Tien, Yang Kai-Chiang, Yeh Kuang-Ting, Sumi Shoichiro, Wang Chen-Chie
Department of Orthopaedic Surgery, Taiwan Adventist Hospital, Taipei 10556, Taiwan.
Department of Orthopedics, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; Department of Orthopedic Surgery, Hualien Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan.
J Orthop Sci. 2017 May;22(3):506-511. doi: 10.1016/j.jos.2016.12.025. Epub 2017 Jan 23.
Rotational alignment of the distal femur is important in total knee arthroplasty. The purpose of this study is to use a roentgenographic technique to evaluate the accuracy of mini-incision total knee arthroplasty (MIS TKA) performed based on the transepicondylar line from the kneeling view.
Totally 32 patients (aged from 64 to 80 years with an average of 70.9 years) with 46 cases of knee osteoarthritis received MIS TKA were registered. Before surgery, the condylar twist angle was measured from the kneeling view. The bone cut for the external rotation was completed, with regard to the condylar twist angle. The control group including 26 patients (aged from 50 to 89 years with an average of 69.7 years) with 42 cases of knee osteoarthritis underwent TKA with built-in cutting jig design 3 degrees of femoral external rotation. This study is a prospective continuous-time duration analysis study. The level of evidence is IIc.
The mean condylar twist angle was 5.1° in the experimental group and 5.4° in the control group. The mean postoperative angle between the clinical epicondylar axis and the posterior condylar line of the femoral component was 0.46°. The same postoperative angle of the built-in external rotation in the control group was 2.7°. The condylar twist angle was significantly more accurate than the built-in design.
Our result substantiates that the kneeling view is practicable and reproducible as the cutting reference for femoral external rotation. The accuracy of the kneeling view shows that the epicondylar axis can be used in smaller wound surgery, such as MIS TKA.
Level IIc.
在全膝关节置换术中，股骨远端的旋转对线很重要。本研究的目的是使用一种X线摄影技术，评估基于跪姿位经髁间线进行的微创全膝关节置换术（MIS TKA）的准确性。
共纳入32例患者（年龄64至80岁，平均70.9岁），46侧膝关节骨关节炎接受MIS TKA手术。术前，从跪姿位测量髁扭转角。根据髁扭转角完成股骨外旋截骨。对照组包括26例患者（年龄50至89岁，平均69.7岁），42侧膝关节骨关节炎，采用内置切割导向器设计为股骨外旋3°进行全膝关节置换术。本研究为前瞻性连续时间分析研究。证据级别为IIc级。
试验组平均髁扭转角为5.1°，对照组为5.4°。术后股骨假体临床髁上轴与后髁线之间的平均角度为0.46°。对照组内置外旋的相同术后角度为2.7°。髁扭转角比内置设计更准确。
我们的结果证实，跪姿位作为股骨外旋的截骨参考是可行且可重复的。跪姿位的准确性表明，髁上轴可用于较小切口手术，如MIS TKA。
IIc级。
