Evans P D, Marshall P D, McDonnell B, Richards J, Evans E J
Department of Orthopaedic Surgery, University of Wales, College of Cardiff, United Kingdom.
J Arthroplasty. 1995 Feb;10(1):43-6. doi: 10.1016/s0883-5403(05)80099-3.
Twenty-one caucasian, adult cadaveric tibiae were prepared as for knee arthroplasty using an intramedullary cutting guide. The instrumentation was used to produce slots in the proximal tibia into which Kirschner wires were placed as radio-opaque markers for subsequent anteroposterior and lateral radiographs. The anatomic axis of the tibia and lines perpendicular to the wire markers were drawn on the radiographs and the angle between the two lines was measured to assess the accuracy of the cuts. Seventy-one percent of the tibial cuts were found to be within 2 degrees of the anatomic axis on the anteroposterior radiograph (mean, 2.1 degrees), while on the lateral radiograph, 81% of the cuts were within 2 degrees (mean, 1.8 degrees). There was a significant tendency to position the bone cuts in varus (P < .05), although this did not correlate with varus or valgus deformity of the bones. There was no consistent tendency to anterior or posterior tilt on the lateral radiograph (P > .05). The results compare favorably with those obtained from a specialist unit using an extramedullary alignment system. The authors conclude that the tibial intramedullary guide can lead to preparation of the proximal tibia for knee arthroplasty as accurately as the conventional extramedullary system.
使用髓内切割导向器将21具成年白人尸体胫骨按照膝关节置换术的要求进行准备。使用该器械在胫骨近端制作狭槽，将克氏针作为不透射线的标记物插入狭槽，用于后续的前后位和侧位X线片拍摄。在X线片上画出胫骨的解剖轴和与标记线垂直的线，并测量两条线之间的角度，以评估切割的准确性。结果发现，在前后位X线片上，71%的胫骨切割角度与解剖轴相差在2度以内（平均为2.1度）；而在侧位X线片上，81%的切割角度在2度以内（平均为1.8度）。尽管骨切割角度的内翻与骨骼的内翻或外翻畸形无关，但骨切割有显著的内翻倾向（P <.05）。在侧位X线片上，没有一致的前倾或后倾倾向（P >.05）。这些结果与使用髓外对线系统的专业单位所获得的结果相比具有优势。作者得出结论，胫骨髓内导向器能够像传统的髓外系统一样准确地为膝关节置换术准备胫骨近端。
