内外侧单髁膝关节置换患者腘动脉位置与胫骨截骨平面的关系：术前磁共振成像与术中发现的回顾性分析

Relationship between the location of the popliteal artery and the tibial osteotomy plane in patients with medial and lateral unicompartmental knee arthroplasty: A retrospective analysis of preoperative magnetic resonance imaging and intraoperative findings.

作者信息

Kubo Tatsuya, Takahashi Tsuneari, Kimura Yuya, Ajiki Takashi, Yasuda Eri, Takeshita Katsushi

机构信息

Department of Orthopaedic Surgery, Shin Oyama City Hospital, Oyama, Japan.

Department of Orthopaedics, School of Medicine, Jichi Medical University, Shimotsuke, Japan.

出版信息

SICOT J. 2025;11:1. doi: 10.1051/sicotj/2024058. Epub 2025 Jan 13.

DOI:10.1051/sicotj/2024058

PMID:39803977

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11727081/

Abstract

PURPOSE

To clarify the location of the popliteal artery (PA) is relative to the tibial osteotomy plane in patients with medial and lateral unicompartmental knee osteoarthritis (KOA) undergoing UKA.

METHODS

Preoperative MRI and postoperative radiographs obtained from 50 patients with unicompartmental KOA who underwent fixed-bearing UKA were analyzed. The amount of tibial resection was determined from the surgical records, and a line was drawn parallel to the tibial posterior tilt angle on the sagittal MR image to create a virtual tibial cut line. The tibial resection width measured from the anteroposterior image of the postoperative radiograph was projected onto the transverse plane containing the intersection between the virtual tibial cut line and the posterior tibial cortex, after which a line was drawn parallel to the medial or lateral intercondylar ridge. We then determined whether the PA was within an extension of the osteotomy area. The shortest distance (Distance 1) between the posterior tibial cortex and the PA within the osteotomy area was measured. In addition, the shortest distance between the line extending the osteotomy posteriorly and the PA was measured (Distance 2).

RESULTS

The medial UKA (group M) and lateral UKA (group L) group comprised 41 and 9 cases. The percentage of PA located behind the osteotomy plane was significantly higher in group L than in group M [6/9 knees (66.7%) vs. 2/41 knees (4.9%); P < 0.001]. The distance 1 was 12.6 (4.3) mm in group M and 7.9 (3.7) mm in group L (P = 0.004). The distance2 was 11.1 (4.9) mm in group M and 2.6 (3.5) mm in group L (P < 0.001).

CONCLUSION

During lateral UKA, the PA was often located behind the tibial osteotomy plane and close to the posterior tibial cortex. Nearly 5% of medial UKAs, the artery was located behind the osteotomy plane.

LEVEL OF EVIDENCE

Retrospective comparative LEVEL III study.

摘要

目的

明确接受单髁膝关节置换术（UKA）的内侧和外侧单髁膝关节骨关节炎（KOA）患者腘动脉（PA）相对于胫骨截骨平面的位置。

方法

分析50例接受固定平台UKA的单髁KOA患者的术前MRI和术后X线片。根据手术记录确定胫骨截骨量，并在矢状面MR图像上绘制一条与胫骨后倾角平行的线，以创建虚拟胫骨截骨线。将术后X线片前后位图像测量的胫骨截骨宽度投影到包含虚拟胫骨截骨线与胫骨后皮质交点的横断面上，然后绘制一条与内侧或外侧髁间嵴平行的线。然后确定PA是否在截骨区域的延长范围内。测量截骨区域内胫骨后皮质与PA之间的最短距离（距离1）。此外，测量截骨向后延伸线与PA之间的最短距离（距离2）。

结果

内侧UKA组（M组）41例，外侧UKA组（L组）9例。L组中PA位于截骨平面后方的百分比显著高于M组[6/9膝（66.7%）对2/41膝（4.9%）；P<0.001]。M组距离1为12.6（4.3）mm，L组为7.9（3.7）mm（P=0.004）。M组距离2为11.1（4.9）mm，L组为2.6（3.5）mm（P<0.001）。