膝骨关节病股骨后髁偏心距和偏心率特点及其与胫骨平台后倾角相关性分析

doi:10.3969/j.issn.1006-7795.2019.04.007

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (4): 528-532.doi: 10.3969/j.issn.1006-7795.2019.04.007

• 骨科前沿技术与学术论坛 • 上一篇下一篇

膝骨关节病股骨后髁偏心距和偏心率特点及其与胫骨平台后倾角相关性分析

曾俊杰, 郭艾

首都医科大学附属北京友谊医院骨科, 北京 100050

收稿日期:2019-05-29 出版日期:2019-07-21 发布日期:2019-07-19
通讯作者: 郭艾 E-mail:ruanxiangyan@163.com
基金资助:
骨关节炎早期防治技术研究（D171100003217001）。

Characteristics of posterior condylar offset and ratio in osteoarthritis and relationship between posterior condylar offset/posterior condylar offset ratio and posterior tibial slope

Zeng Junjie, Guo Ai

Department of Orthopedic, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received:2019-05-29 Online:2019-07-21 Published:2019-07-19
Supported by:
This study was supported by Prevention and Treatment on Early Stage of Osteoarthritis(D171100003217001).

摘要/Abstract

摘要： 目的比较中国人群不同性别、不同级别膝骨关节病患者股骨后髁偏心距（posterior condylar offset，PCO）及偏心率（posterior condylar offset ratio，PCOR）差异，分析股骨后髁偏心距和偏心率与胫骨平台后倾角（posterior tibial slope，PTS）的影像学相关性。方法纳入2018年2月至2018年6月首都医科大学附属北京友谊医院膝骨关节病患者200例，男性63例（112膝），女性137例（249膝），通过膝关节标准正侧位片评估膝骨关节病严重程度，测量PCO、股骨远端直径（anterior-posterior dimension，ACP）及PTS，计算PCOR （PCO/ACP）。应用双因素方差分析比较不同性别、不同级别膝骨关节病患者PCO/PCOR差异。应用Pearson相关分析探索膝骨关节病患者PCO/PCOR与PTS的相关性。结果男性PCO较女性更大；男女患者PCOR差异无统计学意义。不同级别间女性患者PCO及PCOR差异无统计学意义。男性Ⅱ级患者PCO较Ⅲ/Ⅳ级患者偏小（P=0.004，P=0.008），而Ⅲ级与Ⅳ级患者PCO差异无统计学意义。不同级别间男性PCOR亦差异无统计学意义。同时PCO与PTS不具有相关性，且不受性别或级别因素影响；PCOR与PTS的关系与级别有关，与性别无关：Ⅱ级患者PCOR与PTS具有相关性（r=0.226 9，P=0.02），Ⅲ级及Ⅳ级患者无类似相关性。结论膝骨关节病的疾病进展对男性患者PCO的影响较女性更大。疾病进展所致骨质增生与骨赘形成不影响股骨远端的解剖学特点，但对股骨与胫骨后间室解剖结构的相关性有一定影响，随着疾病进展，两者原有的相关性逐渐消失。

关键词: 膝骨关节病, 股骨后髁偏心距, 股骨后髁偏心率, 胫骨平台后倾角

Abstract: Objective To analyze the difference of posterior condylar offset(PCO) and posterior condylar offset ratio(PCOR) in different sex or level groups and figure out the relationship between the PCO/PCOR and posterior tibial slope(PTS). Methods Totally 200 patients diagnosed with osteoarthritis of knee during February 2018 to June 2018 were rolled in, including 63 men(112 knees) and 137 women(249 knees). The osteoarthritis level was evaluated, PCO and anterior-posterior dimension(ACP) of distal femur was measured and the PCOR(PCO/ACP) was evaluated through anterior and lateral radiographs of the knee. Two-ways ANOVA was used to analyze the difference of PCO/PCOR in different groups, Pearson relation analysis was used to analyze the relationship between the PCO/PCOR and PTS. Results The PCO of male was larger than level-matched female; there was no difference in PCOR between male and female. There was no difference in PCO and PCOR of female among three levels. The male in level Ⅱ have smaller PCO than level Ⅲ and IV (P=0.004, P=0.008), no more difference found between level Ⅲ and IV; and there was no difference exists in PCOR of male among three levels. PCO was not related to PTS in neither sex nor level groups, the relationship between the PCOR and PTS only depends on the level rather than the sex, and this relationship only exists in level Ⅱ(r=0.226 9, P=0.02). Conclusion The osteoarthritis progression has much more influence on male than female. Hyperostosis and osteophyte have no effect on anatomical characteristics of distal femur, but on the anatomical relationship between femur and tibia. The relationship between PCOR and PTS is gradually disappearing with disease progression.

Key words: osteoarthritis of knee, posterior condylar offset, posterior condylar offset ratio, posterior tibial slope

中图分类号:

曾俊杰, 郭艾. 膝骨关节病股骨后髁偏心距和偏心率特点及其与胫骨平台后倾角相关性分析[J]. 首都医科大学学报, 2019, 40(4): 528-532.

Zeng Junjie, Guo Ai. Characteristics of posterior condylar offset and ratio in osteoarthritis and relationship between posterior condylar offset/posterior condylar offset ratio and posterior tibial slope[J]. Journal of Capital Medical University, 2019, 40(4): 528-532.

参考文献 16

[1]	Bellemans J, Banks S, Victor J, et al. Fluoroscopic analysis of the kinematics of deep flexion in total knee arthroplasty[J]. J Bone Joint Surg Br, 2002,84(1):50-53.
[2]	Onodera T, Majima T, Nishiike O, et al. Posterior femoral condylar offset after total knee replacement in the risk of knee flexion contracture[J].J Arthroplasty, 2013,28(7):1112-1116.
[3]	Wang W,Tsai T Y,Yue B,et al.Posterior femoral condylar offsets of a Chinese population[J]. Knee,2014,21(2):553-556.
[4]	Balcarek P,Hosseini A S A, Streit U, et al. Sagittal magnetic resonance imaging-scan orientation significantly influences accuracy of femoral posterior condylar offset measurement[J]. Arch Orthop Trauma Surg,2018,138(2):267-272.
[5]	Voleti P B, Stephenson J W, Lotke P A, et al. No sex differences exist in posterior condylar offsets of the knee[J]. Clin Orthop Relat Res,2015,473(4):1425-1431.
[6]	Malviya A, Lingard E A, Weir D J, et al. Predicting range of movement after knee replacement:the importance of posterior condylar offset and tibial slope[J].Knee Surg,Sports Traumatol,Arthrosc,2009,17(5):491-498.
[7]	Cinotti G, Sessa P, Ripani F R,et al. Correlation between posterior offset of femoral condyles and sagittal slope of the tibial plateau[J].J Anat,2012,221(5):452-458.
[8]	Kim J.Effect of posterior femoral condylar offset and posterior tibial slope on maximal flexion angle of the knee in posterior cruciate ligament sacrificing total knee arthroplasty[J].Knee Surg Relat Res,2013,25(2):54-59.
[9]	Johal P,Hassaballa M A, Eldridge J D,et al.The posterior condylar offset ratio[J].Knee,2012,19(6):843-845.
[10]	Song S J, Bae D K, Kim K I, et al.Changes in femoral posterior condylar offset, tibial posterior slope angle,and joint line height after cruciate-retaining total knee arthroplasty[J].Knee Surg Relat Res,2016,28(1):27-33.
[11]	Yoshiya S, Matsui N, Komistek R D, et al. In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions[J].J Arthroplasty,2005,20(6):777-783.
[12]	Massin P,Gournay A. Optimization of the posterior condylar offset, tibial slope, and condylar roll-back in total knee arthroplasty[J].J Arthroplasty,2006,21(6):889-896.
[13]	Han H S, Kang S B. Interactive effect of femoral posterior condylar offset and tibial posterior slope on knee flexion in posterior cruciate ligament-substituting total knee arthroplasty[J].Knee,2018,25(2):335-340.
[14]	Arabori M, Matsui N, Kuroda R, et al. Posterior condylar offset and flexion in posterior cruciate-retaining and posterior stabilized TKA[J].J Orthop Sci,2008,13(1):46-50.
[15]	Costanzo J A, Aynardi M C, Peters J D, et al. Patellar clunk syndrome after total knee arthroplasty; risk factors and functional outcomes of arthroscopic treatment[J].J Arthroplasty,2014,29(9 Suppl):201-204.
[16]	Weinberg D S, Gebhart J J, Wera G D.An anatomic investigation into the relationship between posterior condylar offset and posterior tibial slope of one thousand one hundred thirty eight cadaveric knees[J].J Arthroplasty,2017,32(5):1659-1664.

膝骨关节病股骨后髁偏心距和偏心率特点及其与胫骨平台后倾角相关性分析

Characteristics of posterior condylar offset and ratio in osteoarthritis and relationship between posterior condylar offset/posterior condylar offset ratio and posterior tibial slope

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