Ries M D
Department of Orthopaedic Surgery, University of California at San Francisco, 94143-0728, USA.
J Arthroplasty. 1998 Jan;13(1):85-91. doi: 10.1016/s0883-5403(98)90080-8.
A method of orienting the femoral and tibial bone cuts relative to the endosteal cortex of the femur and tibia was used in 32 patients who underwent revision total knee arthroplasty. The mean orientation of the femoral component was 96.74 degrees +/- 1.03 degrees, mean orientation of the tibial baseplate was 90.71 degrees +/- 1.10 degrees, mean anatomic tibiofemoral alignment was 7.42 degrees +/- 1.69 degrees of valgus, and mean mechanical tibiofemoral alignment was 1.09 degrees +/- 1.83 degrees of valgus. Mean tibial bowing was 1.63 degrees +/- 1.57 degrees of valgus, and mean femoral bowing was 0.58 degrees +/- 1.53 degrees of varus. Valgus tibial bowing was correlated with valgus orientation of the tibial component (r = .86, P < .000001), and varus femoral bowing was correlated with orientation of the femoral component (r = .54, P = .0054). Referencing the implant position from the endosteal cortex of the intramedullary canals provides a reliable method of achieving satisfactory alignment in most revision total knee arthroplasties; however, bowing of the femur or tibia can affect alignment.
32例行全膝关节置换翻修术的患者采用了一种使股骨和胫骨截骨相对于股骨和胫骨骨内膜皮质定向的方法。股骨假体的平均定向角度为96.74度±1.03度，胫骨基板的平均定向角度为90.71度±1.10度，平均解剖学胫股对线为外翻7.42度±1.69度，平均机械学胫股对线为外翻1.09度±1.83度。胫骨平均弓度为外翻1.63度±1.57度，股骨平均弓度为内翻0.58度±1.53度。胫骨外翻弓度与胫骨假体的外翻定向相关（r = 0.86，P < 0.000001），股骨内翻弓度与股骨假体的定向相关（r = 0.54，P = 0.0054）。以内髓腔骨内膜皮质为参照确定植入物位置，为大多数全膝关节置换翻修术实现满意的对线提供了一种可靠的方法；然而，股骨或胫骨的弓度会影响对线。
