Teter K E, Bregman D, Colwell C W
Orthopedic Sports Medicine Clinic of Topeka, KS, USA.
Clin Orthop Relat Res. 1995 Dec(321):117-21.
The angle formed between the femoral anatomic axis and the femoral prosthesis was measured on radiographs of 201 total knee arthroplasties. The radiographs were taken on a 51 inch x 14 inch cassette and had to have satisfactory centering and minimal rotation to be included. All total knee arthroplasties had intramedullary femoral alignment. The mean femoral component angle (relative to the femoral anatomic axis) was 6.1 degrees valgus, with a standard deviation of 2 degrees and a range from 2 degrees to 12 degrees valgus. Seventeen knees (8.5%) had a femoral component angle that was < or = 2 degrees valgus or > or = 10 degrees valgus. In 4 knees, medial femoral bowing of the distal third of the femoral shaft caused an excessive valgus cut. In 7 knees, a capacious femoral canal was present that potentially allowed for divergence of the relatively undersized guide rod in the canal. Overall, 8.5% of cuts were believed to be less than ideal. Preoperative radiographs of the entire femur should identify patients in whom errors are more likely and allow for templating the amount of distal femoral bone to be resected. Extra caution is needed in bowed femora and in capacious femoral canals.
在201例全膝关节置换术的X线片上测量股骨解剖轴与股骨假体之间形成的角度。X线片采用51英寸×14英寸的暗盒拍摄，且必须具有满意的中心定位和最小的旋转才能纳入。所有全膝关节置换术均采用股骨髓内对线。股骨组件的平均角度（相对于股骨解剖轴）为外翻6.1度，标准差为2度，外翻范围为2度至12度。17个膝关节（8.5%）的股骨组件角度为≤2度外翻或≥10度外翻。在4个膝关节中，股骨干远端三分之一的内侧股骨弯曲导致过度的外翻截骨。在7个膝关节中，存在宽大的股骨髓腔，这可能会使相对较小的导杆在髓腔内发生偏移。总体而言，8.5%的截骨被认为不太理想。术前整个股骨的X线片应识别出更可能出现误差的患者，并允许对远端股骨切除量进行模板测量。对于弯曲的股骨和宽大的股骨髓腔，需要格外小心。
