背景:自全膝关节置换术开始以来,植入物对齐一直是讨论的中心点。尽管讨论的对齐理论多种多样,植入物的设计是统一的,这应该是基于“平均膝盖”。“假体设计和现代对准理论的稳步升级已经实现了改进。然而,膝关节置换术继续承受着相当比例的不满意患者的负担。在目前的膝关节置换术中,股骨植入物对齐由背侧和远端髁轴参考。没有充分考虑髌股关节变异。股骨髁的主要背侧和远端参考决定了前膝关节的术后形状。本研究调查了背侧和远端关节参数与髌股关节之间的可能关系。
方法:在这项探索性回顾性单中心研究中,评估了100个天然膝关节的MRI横截面图像。通过根据皮尔逊确定参数相关性,这项研究调查了独立变量“股骨后髁角度”和“股骨远端外侧角度”是否与“滑车外侧倾斜”有关,“髌骨倾斜”,和“平分偏移”。
结果:后髁角与外侧滑车倾角显著相关,髌骨倾斜,和平分偏移。与髌骨倾斜和平分偏移呈正相关,而与滑车外侧倾斜呈负相关。股骨远端外侧角度与研究参数无关。
结论:滑车外侧倾角随着股骨后髁角的增大而减小。全膝关节置换术中股骨组件的后部参考同时建立了前膝关节的形状。我们的结果表明,后髁角度的增加与天然膝盖的扁平外侧滑车倾斜显着相关,并表明全膝关节置换术中存在系统的生物力学冲突。
BACKGROUND: Since the beginning of total knee arthroplasty, implant alignment has been a central point of discussion. As diverse as the discussed alignment theories are, as uniform is the implant design, which is supposed to be based on the \"average knee.\" Steady upgrades in prosthesis design and modern alignment theories have achieved improvements. However, knee arthroplasty continues to be burdened by a significant percentage of dissatisfied patients. In current knee arthroplasty, femoral implant alignment is referenced by the dorsal and distal condylar axes. The patellofemoral joint variance is not sufficiently considered. Predominantly dorsal and distal referencing at the femoral condyle determines the postoperative shape of the anterior knee joint. The present study investigated a possible relationship between dorsal and distal joint parameters and the patellofemoral joint.
METHODS: In this explorative retrospective monocentric study, MRI cross-sectional images of 100 native knee joints were evaluated. By determining parametric correlations according to Pearson, the study investigates whether the independent variables \"posterior femoral condyle angle\" and \"lateral distal femoral angle\" are related to \"lateral trochlear inclination\", \"patella tilt\", and \"bisect offset\".
RESULTS: The posterior condylar angle significantly correlates with lateral trochlear inclination, patella tilt, and bisect offset. There is a positive correlation with patella tilt and bisect offset but a negative correlation with lateral trochlear inclination. The lateral distal femoral angle did not correlate with the studied parameters.
CONCLUSIONS: The lateral trochlear inclination decreases with an increased posterior femoral condylar angle. The posterior referencing of the femoral component in total knee arthroplasty simultaneously establishes the shape of the anterior knee joint. Our results indicate that increasing posterior condyle angles significantly correlate with flattened lateral trochlear inclinations in native knees and suggest a systematic biomechanical conflict in total knee arthroplasty.