Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China.
Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan, China.
Knee. 2021 Mar;29:510-519. doi: 10.1016/j.knee.2021.03.003. Epub 2021 Mar 20.
The systems for precisely locating the joint line during primary and revision total knee arthroplasty are still controversial, and they should be better evaluated in the Chinese population.
A total of 451 standard anteroposterior knee radiographs from 451 healthy Chinese people (283 males and 168 females, the average age of 33.26 years, range 20-50 years) were included to measure the femoral width (FW) and the distances from the adductor tubercle (AT), the medial epicondyle (ME), the lateral epicondyle (LE), and the fibular head (FH) to the joint line (JL). Correlation between FW and distances from landmarks to the joint line was evaluated using Pearson correlation coefficient, and the ratios of ATJL, MEJL, LEJL, FHJL to FW were calculated.
The average distances from the AT, the ME, the LE, the FH to the JL were 49.4 ± 5.0 mm, 28.3 ± 3.1 mm, 26.9 ± 2.9 mm, 20.0 ± 4.0 mm, respectively. An excellent linear correlation was found between FW and the distance from AT to the joint line (R = 0.836, R = 0.698); it was more reliable than the LE (R = 0.686, R = 0.471) and the ME (R = 0.672, R = 0.452). The average ratios of ATJL/FW, MEJL/FW, LEJL/FW were 0.553, 0.317, and 0.302, respectively. There were significant differences between our results and the studies based on the Western people.
The AT can be used as a reliable landmark to locate the JL precisely by the formula (ATJL = 0.548 × FW in males; ATJL = 0.562 × FW in females) in the Chinese population. The LE and ME can be the second choices. Moreover, it may be better to use ratios from the research based on the same race.
在初次全膝关节置换术和翻修全膝关节置换术中，精确定位关节线的系统仍存在争议，应在中国人群中进行更好的评估。
共纳入 451 例健康中国人的标准前后位膝关节 X 线片（283 例男性，168 例女性，平均年龄 33.26 岁，范围 20-50 岁），测量股骨宽度（FW）和来自收肌结节（AT）、内上髁（ME）、外上髁（LE）和腓骨头（FH）到关节线（JL）的距离。采用 Pearson 相关系数评估 FW 与各标志点至关节线距离的相关性，并计算 ATJL/FW、MEJL/FW、LEJL/FW 的比值。
AT、ME、LE、FH 到 JL 的平均距离分别为 49.4±5.0mm、28.3±3.1mm、26.9±2.9mm、20.0±4.0mm。FW 与 AT 到关节线的距离之间存在极好的线性相关性（R=0.836，R=0.698），这比 LE（R=0.686，R=0.471）和 ME（R=0.672，R=0.452）更可靠。ATJL/FW、MEJL/FW、LEJL/FW 的平均比值分别为 0.553、0.317 和 0.302。我们的结果与基于西方人群的研究结果存在显著差异。
在中国人群中，通过公式（男性 ATJL=0.548×FW；女性 ATJL=0.562×FW），AT 可作为精确定位 JL 的可靠标志点。LE 和 ME 可以作为第二选择。此外，使用来自同一种族的研究中的比值可能会更好。
