[1]柳明忠,施建辉,谢俊杰,等.开放楔形胫骨高位截骨术后膝关节的关节线收敛角影像学分析[J].中国医学物理学杂志,2021,38(11):1381-1386.[doi:DOI:10.3969/j.issn.1005-202X.2021.11.012]
　LIU Mingzhong,SHI Jianhui,XIE Junjie,et al.Imaging analysis on the joint line convergence angle of the knee joint after open-wedge high tibial osteotomy[J].Chinese Journal of Medical Physics,2021,38(11):1381-1386.[doi:DOI:10.3969/j.issn.1005-202X.2021.11.012]
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开放楔形胫骨高位截骨术后膝关节的关节线收敛角影像学分析()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
38卷
期数:
2021年第11期
页码:
1381-1386
栏目:
医学影像物理
出版日期:
2021-11-26

文章信息/Info

Title:
Imaging analysis on the joint line convergence angle of the knee joint after open-wedge high tibial osteotomy
文章编号:
1005-202X（2021）111-1381-06
作者:
柳明忠1; 施建辉1; 谢俊杰1; 陈杰云2
1.福建医科大学附属泉州第一医院骨科， 福建 泉州 362100； 2.福建医科大学附属泉州第一医院影像科， 福建 泉州 362100
Author(s):
LIU Mingzhong1;  SHI Jianhui1;  XIE Junjie1;  CHEN Jieyun2
1. Department of Orthopedics, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362100, China 2. Department of Imaging, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362100, China
关键词:
开放楔形胫骨高位截骨术; 关节线收敛角; 膝关节活动度; 膝关节评分
Keywords:
Keywords: open-wedge high tibial osteotomy joint line convergence angle knee joint range of motion knee joint score
分类号:
R681.8
DOI:
DOI:10.3969/j.issn.1005-202X.2021.11.012
文献标志码:
A
摘要:
目的：研究开放楔形胫骨高位截骨术前仰卧位关节线收敛角（JLCA）与术后站立位JLCA的关系。方法：选取接受开放楔形胫骨高位截骨术治疗的84名膝关节内侧骨性关节炎患者，根据术前JLCA<4°（低JLCA组）和≥4°（高JLCA组）对患者进行分组。术前和术后1年分别测量膝关节活动度（ROM）、髋-膝-踝角（HKA）、负重线（WBL）比、美国膝关节协会（AKS）膝关节评分和功能评分、Lysholm膝关节评分，膝关节损伤骨性关节炎预后评分（KOOS）。结果：术前，高JLCA组的HKA、WBL比和潜在外侧松弛度明显小于低JLCA组（P<0.05）。高JLCA组的Kellgren和Lawrence评分高于低JLCA组（P<0.05）。两组之间在胫骨后倾斜度（TPS）、内侧近端胫骨角（MPTA）、总JLCA和关节线倾斜度（JLO）方面无明显差异（P>0.05）。高JLCA组的仰卧位JLCA、ΔJLCA、内翻JLCA、外翻JLCA和潜在内侧松弛度高于低JLCA组（P<0.05）。低JLCA组的ROM相比高JLCA组的运动范围大（P<0.05）。两组之间的任何临床评分均无明显差异（均P>0.05）。术后，在HKA、矫正误差、WBL比、TPS、MPTA骨矫正、总JLCA或JLO之间未发现明显差异（P>0.05）。但高JLCA组的矫正角和软组织矫正高于低JLCA组（P<0.05）。高JLCA组的术后JLCA、ΔJLCA、内翻JLCA和外翻JLCA高于低JLCA组（P<0.05）。低JLCA组的术后ROM高于高JLCA组（P<0.05）。两组之间的任何术后临床评分均无明显差异（P>0.05）。术前仰卧位JLCA与术后站立位JLCA相关（r=0.696, P<0.001）。结论：在控制术中JLCA时，术后冠状面排列不受JLCA改变和低JLCA组与高JLCA组软组织矫正差异的影响。然而，与目标冠状面排列相比，两组仍然存在过度矫正。
Abstract:
Abstract: Objective To study the relationship between the joint line convergence angle (JLCA) in the supine position before open-wedge high tibial osteotomy and JLCA in the standing position after operation. Methods A total of 84 patients receiving open-wedge high tibial osteotomy for medial knee osteoarthritis were selected and divided into low JLCA group (preoperative JLCA<4°) and high JLCA group (preoperative JLCA≥4°). Knee joint range of motion (ROM), hip-knee-ankle angle (HKA), weight-bearing line (WBL) ratio, American Knee Society (AKS) knee joint score and function score, Lysholm knee score, and knee injury and osteoarthritis outcome score (KOOS) were measured before and 1 year after operation. Results Before operation, HKA, WBL ratio and potential lateral laxity in high JLCA group were significantly lower than those in low JLCA group (P<0.05), and the Kellgren and Lawrence scores of high JLCA group were higher than those of low JLCA group (P<0.05). There was no significant difference in TPS, MPTA, total JLCA or JLO between two groups (P>0.05). Compared with low JLCA group, high JLCA group had higher supine JLCA, ΔJLCA, inversion and eversion JLCA and potential medial laxity (P<0.05), and smaller ROM (P<0.05). No significant difference was found in any clinical scores between two groups (all P>0.05). After operation, the differences between two groups in HKA, correction error, WBL ratio, TPS, MPTA bone correction, total JLCA or JLO were trivial (P>0.05). However, the correction angle and soft tissue correction of high JLCA group were larger than those of low JLCA group (P<0.05) and the postoperative JLCA, ΔJLCA, inverted and everted JLCA in high JLCA group were higher than those in low JLCA group (P<0.05) and the postoperative ROM of low JLCA group was larger than that of high JLCA group (P<0.05). There was no significant difference in any postoperative clinical scores between two groups (P>0.05). JLCA in the supine position before operation was correlated with JLCA in the standing position after operation (r=0.696, P<0.001). Conclusion When controlling intraoperative JLCA, the postoperative coronal plane arrangement is not affected by the changes in JLCA and the difference in soft tissue correction between low and high JLCA groups. However, compared with the target coronal plane arrangement, overcorrection still exists in two groups.

备注/Memo

备注/Memo:
【收稿日期】2021-05-02 【基金项目】泉州市科技计划项目（2018Z081） 【作者简介】柳明忠，硕士，副主任医师，研究方向：创伤骨科及关节外科，E-mail: yongqianglliuyq@163.com
更新日期/Last Update: 2021-11-27