股骨髁间切迹是全膝关节置换术中股骨远端切除深度的准确标志。

IF 4.1 Q1 ORTHOPEDICS
David W Liu, Sara Martinez Martos, Yifei Dai, Elaine M Beller
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引用次数: 2

摘要

导读:传统上,全膝关节置换术中股骨远端切除的深度是从最突出的股骨远端髁开始。这种手术技术不考虑关节表面的病理改变或膝关节畸形的严重程度。据推测,在初次全膝关节置换术中,股骨髁间切迹是临床上可靠且更准确的股骨远端切除深度的替代标志。方法:应用计算机导航测量406例全膝关节置换术中股骨远端股骨内外侧髁及髁间切迹的切除深度。采用标准差、95%置信区间和方差分析骨切除深度之间的可变性。对结果进行至少12个月的临床随访,以进一步了解和验证分析。结果:内髁平均切除深度为10.7 mm,外髁平均切除深度为7.9 mm,股骨髁间切迹平均切除深度为1.9 mm。股骨髁间切迹在三个评估的标志中切除深度方差最小,为1.7 mm2,而股骨内侧髁为2.8 mm2,股骨外侧髁为5.1 mm2。髁间切迹参考具有最低的标准差和95%的置信区间。参考切迹的切除深度对术前屈曲挛缩的程度不敏感,而内侧和外侧髁对屈曲挛缩的程度敏感。对于膝内翻畸形,股骨远端切迹深度平均为2mm,与股骨假体在髁间区的厚度相对应,而对于膝外翻畸形,切迹与髁间切迹平行。结论:股骨髁间切迹是初次全膝关节置换术中股骨远端适当、准确切除深度的临床实用、可重复性好的标志。证据等级:III级:回顾性队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty.

The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty.

The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty.

The femoral intercondylar notch is an accurate landmark for the resection depth of the distal femur in total knee arthroplasty.

Introduction: Conventionally, the depth of distal femoral resection in total knee arthroplasty is referenced from the most prominent distal femoral condyle. This surgical technique does not consider pathological alterations of articular surfaces or severity of knee deformity. It has been hypothesized that the femoral intercondylar notch is a clinically reliable and more accurate alternative landmark for the resection depth of the distal femur in primary total knee arthroplasty.

Methods: The resection depths of the distal femur at the medial and lateral femoral condyles and intercondylar notch were measured using computer navigation in 406 total knee arthroplasties. Variability between the bone resection depths was analyzed by standard deviation, 95% confidence interval and variance. Clinical follow-up of outcome to a minimum of 12 months was performed to further inform and validate the analysis.

Results: Mean resection depth of the medial condyle was 10.7 mm, of the lateral condyle 7.9 mm and of the femoral intercondylar notch 1.9 mm. The femoral intercondylar notch had the lowest variance in resection depth among the three landmarks assessed, with a variance of 1.7 mm2 compared to 2.8 mm2 for the medial femoral condyle and 5.1 mm2 for the lateral femoral condyle. The intercondylar notch reference had the lowest standard deviation and 95% confidence interval. The resection depth referencing the notch was not sensitive to the degree of flexion contracture pre-operatively, whereas the medial and lateral condyles were. For varus deformed knees, distal femoral resection depth at the notch averaged 2 mm, which corresponds to the femoral prosthesis thickness at the intercondylar region, while for valgus deformed knees, the resection was flush with the intercondylar notch.

Conclusions: The femoral intercondylar notch is a clinically practical and reproducible landmark for appropriate and accurate resection depth of the distal femur in primary total knee arthroplasty.

Level of evidence: Level III: Retrospective cohort study.

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