Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA; Department of Orthopedic Surgery, Showa University Koto Toyosu Hospital, Koto-ku, Tokyo, Japan.
Department of Orthopedic Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Knee. 2023 Mar;41:214-220. doi: 10.1016/j.knee.2022.12.001. Epub 2023 Jan 30.
Few studies exist regarding sagittal alignment describing femur morphology in navigation-aided surgery. This study investigated the three-dimensional (3D) sagittal femoral alignment of the whole femur.
Seventy-three consecutive patients (59 females, 14 males, mean age: 76.1 years), yielding 140 femurs, were included in this study. A computed-tomography-based patient-specific 3D femur model was used to define a mechanical axis-based reference plane. Proximal and distal femoral axis angles (PFA, DFA) to the reference plane were measured in 3D using custom software. PFA and DFA represent the proximal and distal inclination of the femoral anatomical axis in sagittal plane, respectively.
PFA (10.6 ± 1.5°) was greater than DFA (2.6 ± 1.6°; P < 0.0001). DFA in females (2.3 ± 1.4°) was smaller than in males (3.9 ± 1.7°; P < 0.0001).
This is the first report of measurement of femoral sagittal alignment related to both 3D anatomy and decision making of femoral flexion angle using navigation surgery for total knee arthroplasty. This report shows a robust DFA measurement that could be used as a template for femoral implants flexion angle when performing both conventional and navigated total knee arthroplasty.
描述导航辅助手术中股骨形态的矢状位对线的研究较少。本研究调查了整个股骨的三维（3D）矢状位股骨对线。
本研究纳入了 73 例连续患者（59 名女性，14 名男性，平均年龄：76.1 岁），共 140 个股骨。使用基于计算机断层扫描的患者特定 3D 股骨模型定义力学轴基准面。使用定制软件在 3D 中测量股骨近端和远端轴线角（PFA、DFA）与基准面的夹角。PFA 和 DFA 分别代表矢状面股骨解剖轴的近端和远端倾斜度。
PFA（10.6±1.5°）大于 DFA（2.6±1.6°；P<0.0001）。女性的 DFA（2.3±1.4°）小于男性（3.9±1.7°；P<0.0001）。
这是第一篇关于使用导航手术进行全膝关节置换时与 3D 解剖相关并与股骨弯曲角度决策相关的股骨矢状位对线测量的报告。该报告显示了一种强大的 DFA 测量方法，可作为常规和导航全膝关节置换术时股骨假体弯曲角度的模板。
