Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Jishuitan Orthopaedic College of Tsinghua University, Beijing, China.
J Arthroplasty. 2017 Nov;32(11):3539-3543. doi: 10.1016/j.arth.2017.05.048. Epub 2017 Jun 2.
Lateral soft-tissue release can jeopardize the common peroneal nerve (CPN) in total knee arthroplasty for valgus knees. Previous studies reporting safe zones to protect the CPN were based on well-aligned knees. We conducted this study to compare the localization of the CPN in well-aligned knees and in valgus knees.
We conducted a consecutive 3-dimensional radiographic study on magnetic resonance images of 58 well-aligned knees and 39 valgus knees. We measured the distance between the CPN and the tibia, as well as the mediolateral, anteroposterior, and angular location of the CPN. We compared the results between well-aligned knees and valgus knees.
We found that there is an increased distance between the CPN and the tibia at the level of the tibial cut, but not at the joint line in valgus knees. It is safer to release the posterolateral capsule at the tibial side than at the level above this. The angular location and the mediolateral or anteroposterior location of the CPN in valgus knees are similar to those of well-aligned knees.
The location of the CPN in valgus knees is similar to that in well-aligned knees. The previously reported safe zone in well-aligned knees is applicable in valgus knees to protect the CPN.
在外翻膝全膝关节置换术中，外侧软组织松解可能会危及腓总神经（CPN）。以前报道保护 CPN 的安全区域的研究是基于对线良好的膝关节。我们进行这项研究是为了比较对线良好的膝关节和外翻膝关节中 CPN 的定位。
我们对 58 例对线良好的膝关节和 39 例外翻膝关节的磁共振成像进行了连续的 3 维放射影像学研究。我们测量了 CPN 与胫骨之间的距离，以及 CPN 的内外侧、前后和角度位置。我们比较了对线良好的膝关节和外翻膝关节之间的结果。
我们发现，在胫骨截骨水平，外翻膝关节中 CPN 与胫骨之间的距离增加，但在关节线处没有增加。在胫骨侧松解后外侧囊比在以上水平松解更安全。外翻膝关节中 CPN 的角度位置以及内外侧或前后位置与对线良好的膝关节相似。
外翻膝关节中 CPN 的位置与对线良好的膝关节相似。以前在对线良好的膝关节中报道的安全区域适用于保护 CPN 的外翻膝关节。
