背景:本研究的目的是通过关节线会聚角(JLCA)的变化来确定全髋关节置换术(THA)对同侧膝关节的卸载作用,并确定THA后其他冠状影像学参数的变化,并评价JLCA的敏感性。
方法:我们回顾性评估了70例接受单侧THA的患者。髋关节参数,如颈部轴角(NSA),颈部长度,以及股骨偏移和下肢冠状排列参数,例如髋-膝-踝角度(HKA),股骨长度,机械股骨远端外侧角(mLDFA),JLCA,胫骨近端内侧角(MPTA),胫骨远端外侧角(LDTA),测量手术侧和非手术侧的距骨角度(PTA)。我们比较了THA之前和之后1年的所有髋关节和冠状排列参数,以及手术侧所有髋关节和冠状排列参数之间的标准化变化量(Δ),分别。
结果:手术侧的所有平均髋关节和冠状排列参数在THA后1年发生了显着变化;然而,非手术方没有。在操作方面,平均JLCA和PTA在闭合关节侧向间隙的方向上发生变化,从1.81°和0.47°到1.22°和0.11°,分别(p<0.001和0.046)。平均国安局,HKA,mLDFA向外翻方向改变,从129.39°,2.62°,和86.69°到133.54°,1.53°,85.91°,分别(p<0.001)。平均股骨偏移,颈部长度,股骨长度从36.45mm增加,47.83mm,429.20毫米到39.85毫米,55.06mm,和436.33毫米,分别(p<0.001)。平均MPTA和LDTA分别从85.43°和87.50°增加到86.73°和90.38(p<0.001)。JLCA比HKA更容易受到变化的影响,股骨长度,mLDFA,MPTA,和PTA(p<0.05)。
结论:THA后手术侧的JLCA变化比其他冠状排列变化更敏感。根据队列,THA可能会对膝关节的内侧隔室产生卸载作用。
方法:IV;回顾性病例对照和队列研究。
BACKGROUND: The purpose of this study was to determine the unloading effect of total hip arthroplasty (THA) on the ipsilateral knee joint through the joint line convergence angle (JLCA) change and determine the changes in other coronal radiographic parameters after THA, and evaluate the sensitivity of JLCA.
METHODS: We retrospectively assessed 70 patients who underwent unilateral THA. Hip parameters such as neck shaft angle (NSA), neck length, and femoral offset and coronal alignment parameters of the lower extremity such as hip-knee-ankle angle (HKA), femur length, mechanical lateral distal femoral angle (mLDFA), JLCA, medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), and plafond talus angle (PTA) were measured in the operative and non-operative sides. We compared all hip and coronal alignment parameters between before and 1 year after THA, and the amount of standardized changes (Δ) between all hip and coronal alignment parameters on the operative side, respectively.
RESULTS: All mean hip and coronal alignment parameters on the operative side changed significantly 1-year after THA; however, those on the non-operative side did not. On the operative side, mean JLCA and PTA changed in the direction of closing the joint lateral space, from 1.81° and 0.47° to 1.22° and 0.11°, respectively (p<0.001 and 0.046, respectively). Mean NSA, HKA, and mLDFA changed in the valgus direction, from 129.39°, 2.62°, and 86.69° to 133.54°, 1.53°, and 85.91°, respectively (p<0.001). Mean femoral offset, neck length, and femur length increased from 36.45mm, 47.83mm, and 429.20mm to 39.85mm, 55.06mm, and 436.33mm, respectively (p<0.001). Mean MPTA and LDTA increased from 85.43° and 87.50° to 86.73° and 90.38, respectively (p<0.001). JLCA was more vulnerable to change than HKA, femur length, mLDFA, MPTA, and PTA (p<0.05).
CONCLUSIONS: JLCA change on the operative side was more sensitive than changes of other coronal alignments after THA. According to the cohort, THA might have an unloading effect on the medial compartment of the knee joint.
METHODS: IV; retrospective case-control and cohort studies.