Chang Chia-Ming, Wu Wen-Tien, Liu Kuan-Lin, Yeh Kuang-Ting, Peng Cheng-Huan, Chen Ing-Ho
Department of Orthopedic Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2017 Apr-Jun;29(2):104-108. doi: 10.4103/tcmj.tcmj_30_17.
Despite its possible role in knee arthroplasty, the proximal-distal condylar length (PDCL) of the femur has never been reported in the literature. We conducted an anatomic study of the proximal aspect of the medial femoral condyle to propose a method for measuring the PDCL.
Inspection of dried bone specimens was carried out to assure the most proximal condylar margin (MPCM) as the eligible starting point to measure the PDCL. Simulation surgery was performed on seven pairs of cadaveric knees to verify the clinical application of measuring the PDCL after locating the MPCM. Interobserver reliability of this procedure was also analyzed.
Observation of the bone specimens showed that the MPCM is a concavity formed by the junction of the distal end of the supracondylar ridge and the proximal margin of the medial condyle. This anatomically distinctive structure made the MPCM an unambiguous landmark. The cadaveric simulation surgical dissection demonstrated that the MPCM is easily accessed in a surgical setting, making the measurement of the PDCL plausible. The intraclass correlation coefficient was 0.78, indicating good interobserver reliability for this technique.
This study has suggested that the PDCL can be measured based on the MPCM in a surgical setting. PDCL measurement might be useful in joint line position management, selection of femoral component sizes, and other applications related to the proximal-distal dimension of the knee. Further investigation is required.
尽管股骨远近端髁长度（PDCL）在膝关节置换术中可能具有作用，但文献中从未有过相关报道。我们对股骨内侧髁近端进行了一项解剖学研究，以提出一种测量PDCL的方法。
对干燥骨标本进行检查，以确定最近端髁边缘（MPCM）作为测量PDCL的合适起始点。在七对尸体膝关节上进行模拟手术，以验证在确定MPCM后测量PDCL的临床应用。还分析了该操作的观察者间可靠性。
对骨标本的观察表明，MPCM是由髁上嵴远端与内侧髁近端边缘交界处形成的一个凹陷。这种解剖学上独特的结构使MPCM成为一个明确的标志。尸体模拟手术解剖表明，在手术中很容易找到MPCM，使得测量PDCL成为可能。组内相关系数为0.78，表明该技术具有良好的观察者间可靠性。
本研究表明，在手术中可以基于MPCM测量PDCL。PDCL测量可能在关节线位置管理、股骨假体尺寸选择以及其他与膝关节远近端尺寸相关的应用中有用。需要进一步研究。
