足母长伸肌腱外侧缘在类风湿性关节炎患者全膝关节置换术中的应用

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Abstract

Objective In patients with rheumatoid arthritis undergoing total knee replacement，the accuracy of tibia platform osteotomy was estimated by the comparison of the outer edge of the extensor hallucis longus (EHL)tendon before ankle joint with the traditional method as a body surface marker in the center of the talus. Methods Objective To evaluate the preoperative and postoperative X-ray films of 76 primary total knee arthroplasty patients with rheumatoid arthritis in our hospital from 2008 to 2014.Before August 2012，the patients with traditional method were group A.Group A had 30 cases(37 knees)，including 7 males and 23 females with an average age of (63.15±12.15)(range：48~81 y).After August 2012，35 cases(39 knee) with EHL tendon before ankle joint as a reference were group B.Group B had 11 male and 24 female with anaverage age of (68.27±9.46)(range：47~85 y).All the 76 knees were operated using patellar medial incision.The angle (alpha angle) between the coronal line and the mechanical line of the tibia was measured beforeorafter surgery.Angles of (90±2)° were accepted as the normal boundaries while more than 92 degrees are considered as valgus，and below 88 as varus.T-test was used for general data and chi-square test was used for enumeration data.Results There was no significant difference between group A (79.92±6.54)° and group B (80.62±6.36)°before operation.The average post-operative alpha angle of Group A was (88.46±3.88)°and (89.59±2.21)°in the group B.The number of prosthesis alpha angle in normal range in group A was lower than that in group B.The difference was significant (P＝0.026).Conclusion The use of the EHL tendon before ankle joint as a reference improves coronal tibial alignment accuracy of TKA in RA patients.

Key words： extensor hallucis longus rheumatoid arthritis total knee arthroplasty anatomical landmark

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[1]	. [J]. sygkzz, 2021, 27(3): 272-276.