Julliard R, Genin P, Weil G, Palmkrantz P
Département d'Orthopédie, Clinique Mutualiste-Rocheplane, Grenoble.
Rev Chir Orthop Reparatrice Appar Mot. 1993;79(8):625-34.
The tibial slope is an important datum in knee surgery; the levelling by a uni- or bicompartmental prosthesis preserving both cruciate ligaments requires to maintain this slope. The postoperative rehabilitation of the A.C.L. plasties, especially those performed with a patellar tendon and the surgical cure of a genu recurvatum, must integrate this notion. Even if the anatomical slopes are usable in prosthetic surgery, they do not seem precise enough in the field of A.C.L. and tibia recurvatum surgery. In these indications, the authors propose to determine the functional tibial slope defined as being the complement of the angle formed by the tangent to the tibial medial plateau and the lateral mechanical axis of the leg. Measured to an average of 7 degrees on 238 knees, the average median functional slope cannot be deduced from anatomical slopes; it must be measured on a lateral teleradiographic view of the lower limb, the knee being in full extension and X-rayed in true posterior and inferior lateral view.
胫骨坡度是膝关节手术中的一个重要数据;使用保留两条交叉韧带的单髁或双髁假体进行调平需要维持这个坡度。前交叉韧带成形术的术后康复,尤其是那些采用髌腱进行的手术以及膝反屈的手术治疗,必须纳入这一概念。即使解剖学坡度可用于假体手术,但在交叉韧带和胫骨反屈手术领域,它们似乎不够精确。在这些适应证中,作者建议确定功能性胫骨坡度,其定义为胫骨内侧平台切线与小腿外侧机械轴所形成角度的补角。在238个膝关节上测得平均为7度,平均中位功能性坡度无法从解剖学坡度推导得出;它必须在下肢的外侧远距离X线片上测量,膝关节完全伸直,并以真正的后下外侧位进行X线检查。