{"title":"在内侧闭合楔形股骨远端内翻截骨术中进行冠状截骨时应考虑的股骨远端内侧表面形态学。","authors":"Fumiyoshi Kawashima , Ryuichi Nakamura , Akira Okano , Koji Kanzaki","doi":"10.1016/j.knee.2024.12.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>The aim of the present study was to evaluate the morphology of the distal medial femoral surface during coronal osteotomy in medial closed wedge distal femoral varus osteotomy (MCWDFO) using plain CT.</div></div><div><h3>Methods</h3><div>Twenty knees (mean age, 55.3 years) were included. Preoperative CT images were obtained prior to MCWDFO for valgus OA. In the cross-section depicting the starting position of the transverse cut, a curve was drawn that passed through the centre of the femoral cortex, and lines parallel and perpendicular to the surgical epicondylar axis (SEA) were drawn to analyse the medial side. Inflection points on the medial line were defined as P1-P4. The radii of circles passing through P1-P3 (PR, posterior radius) and P2-P4 (AR, anterior radius) were drawn. Values for the PR, AR, and radius ratio (PR/AR) were measured.</div></div><div><h3>Results</h3><div>Based on the PR/AR, the cross-sectional morphologies were classified into 5 triangular types (PR/AR < 0.5), 4 flat types (PR/AR > 0.8), and 11 convex types (PR/AR 0.6 to 0.7).</div></div><div><h3>Conclusion</h3><div>The medial anteroposterior width and flange thickness were easier to assess in the flat type; however, these were difficult to assess in the triangular type with a gentle anterior slope. Surgeons should consider the differences in the anterior slope according to cross-sectional morphologies when performing coronal osteotomy in MCWDFO.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"53 ","pages":"Pages 108-117"},"PeriodicalIF":1.6000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A morphology of the distal medial femoral surface that should be considered when performing coronal osteotomy in medial closed wedge distal femoral varus osteotomy\",\"authors\":\"Fumiyoshi Kawashima , Ryuichi Nakamura , Akira Okano , Koji Kanzaki\",\"doi\":\"10.1016/j.knee.2024.12.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><div>The aim of the present study was to evaluate the morphology of the distal medial femoral surface during coronal osteotomy in medial closed wedge distal femoral varus osteotomy (MCWDFO) using plain CT.</div></div><div><h3>Methods</h3><div>Twenty knees (mean age, 55.3 years) were included. Preoperative CT images were obtained prior to MCWDFO for valgus OA. In the cross-section depicting the starting position of the transverse cut, a curve was drawn that passed through the centre of the femoral cortex, and lines parallel and perpendicular to the surgical epicondylar axis (SEA) were drawn to analyse the medial side. Inflection points on the medial line were defined as P1-P4. The radii of circles passing through P1-P3 (PR, posterior radius) and P2-P4 (AR, anterior radius) were drawn. Values for the PR, AR, and radius ratio (PR/AR) were measured.</div></div><div><h3>Results</h3><div>Based on the PR/AR, the cross-sectional morphologies were classified into 5 triangular types (PR/AR < 0.5), 4 flat types (PR/AR > 0.8), and 11 convex types (PR/AR 0.6 to 0.7).</div></div><div><h3>Conclusion</h3><div>The medial anteroposterior width and flange thickness were easier to assess in the flat type; however, these were difficult to assess in the triangular type with a gentle anterior slope. Surgeons should consider the differences in the anterior slope according to cross-sectional morphologies when performing coronal osteotomy in MCWDFO.</div></div>\",\"PeriodicalId\":56110,\"journal\":{\"name\":\"Knee\",\"volume\":\"53 \",\"pages\":\"Pages 108-117\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-12-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S096801602400245X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S096801602400245X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
A morphology of the distal medial femoral surface that should be considered when performing coronal osteotomy in medial closed wedge distal femoral varus osteotomy
Aims
The aim of the present study was to evaluate the morphology of the distal medial femoral surface during coronal osteotomy in medial closed wedge distal femoral varus osteotomy (MCWDFO) using plain CT.
Methods
Twenty knees (mean age, 55.3 years) were included. Preoperative CT images were obtained prior to MCWDFO for valgus OA. In the cross-section depicting the starting position of the transverse cut, a curve was drawn that passed through the centre of the femoral cortex, and lines parallel and perpendicular to the surgical epicondylar axis (SEA) were drawn to analyse the medial side. Inflection points on the medial line were defined as P1-P4. The radii of circles passing through P1-P3 (PR, posterior radius) and P2-P4 (AR, anterior radius) were drawn. Values for the PR, AR, and radius ratio (PR/AR) were measured.
Results
Based on the PR/AR, the cross-sectional morphologies were classified into 5 triangular types (PR/AR < 0.5), 4 flat types (PR/AR > 0.8), and 11 convex types (PR/AR 0.6 to 0.7).
Conclusion
The medial anteroposterior width and flange thickness were easier to assess in the flat type; however, these were difficult to assess in the triangular type with a gentle anterior slope. Surgeons should consider the differences in the anterior slope according to cross-sectional morphologies when performing coronal osteotomy in MCWDFO.
期刊介绍:
The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee.
The topics covered include, but are not limited to:
• Anatomy, physiology, morphology and biochemistry;
• Biomechanical studies;
• Advances in the development of prosthetic, orthotic and augmentation devices;
• Imaging and diagnostic techniques;
• Pathology;
• Trauma;
• Surgery;
• Rehabilitation.