Kawasaki Makoto, Nagamine Ryuji, Chen Weijia, Ma Yuan, Sakai Akinori, Suguro Toru
Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Center of Artificial Joint and Rheumatism, Fukuoka Tokushukai Medical Center, Kasuga, Japan.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(1):2309499020902592. doi: 10.1177/2309499020902592.
According to the concept of the constitutional varus, the tibial articular surface (TAS) has varus inclination. On the other hand, it has been reported that proximal tibia vara involved medial shift of the TAS. However, it has not been assessed whether varus inclination of the TAS has a correlation with the medial shift. We investigated whether varus inclination of the TAS has a correlation with the medial shift. If there is a correlation between two parameters, the influence of the medial shift of the TAS on the value of the hip-knee-ankle (HKA) angle and the femorotibial angle should be considered.
A total of 112 patients who underwent total knee arthroplasty had anteroposterior view tibia digital radiograph on which five parameters were analyzed. Varus angle of the TAS, the distance between the mechanical axis and the anatomical axis on the articular surface, and the width of the articular surface were measured.
The more the proximal tibia had varus deformity, the more the TAS shift medially would be. Therefore, the mechanical axis does not match the anatomical axis. Because the HKA angle was assessed based on the concept that the mechanical and anatomical axes match on the tibia, this angle may not express the true alignment of the lower extremity in knees with proximal tibia vara.
In varus knees, the proximal tibia has a medial shift of the TAS that may influence the value of the HKA angle.
根据先天性内翻的概念,胫骨关节面(TAS)存在内翻倾斜。另一方面,有报道称近端胫骨内翻涉及TAS的内侧移位。然而,尚未评估TAS的内翻倾斜与内侧移位是否相关。我们研究了TAS的内翻倾斜与内侧移位是否相关。如果两个参数之间存在相关性,则应考虑TAS内侧移位对髋-膝-踝(HKA)角和股胫角值的影响。
总共112例行全膝关节置换术的患者进行了胫骨前后位数字X线摄影,并分析了五个参数。测量了TAS的内翻角、关节面上机械轴与解剖轴之间的距离以及关节面的宽度。
近端胫骨内翻畸形越严重,TAS向内侧移位越明显。因此,机械轴与解剖轴不匹配。由于HKA角是基于胫骨上机械轴与解剖轴匹配的概念进行评估的,该角度可能无法表达近端胫骨内翻膝关节下肢的真实对线情况。
在膝内翻中,近端胫骨存在TAS的内侧移位,这可能会影响HKA角的值。