基于CT三维重建测量膝关节骨关节炎患者股骨远段前偏角的初步研究

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Abstract Objective To analyze the laws of distal femoral sagittal anterior angle (DFSAA) in the patients with knee osteoarthritis preliminary and to discuss the influence that DFSAA will have on the location of the femoral component installation after total knee arthroplasty.Methods The data of 131 patients who took knee arthroplasty between January 2017 and January 2018 were collected.The 3D images of bilateral femurs were acquired by CT full-length scan of bilateral lower limbs，then the DFSAA of 262 femurs were measured separately with Mimics 17.0 software and also analyzed statistically，and finally the measurement results were compared between males and females and between the left side and the right side.Results The DFSAA was (2.51±1.50)° (0.05°~5.74°) on average；it was (2.58±1.59)° in males and (2.50±1.49)° in females，and the difference between males and females was not significant (t-test，P>0.05).For individual patients，the difference of DFSAA between the left side and the right side was 1.039 7° on average (0.01°~3.08°)；and it was less than 2° in 90% patients.When the value of DFSAA was 3° or less，the incidence of the notch was 4.48%.When the value of DFSAA was greater than 3°，the incidence of the notch was 18.37%；there were differences between the two groups to compare (chi-square test，P＝0.028).Conclusion The value of DFSAA varies among the patient with knee osteoarthritis，which should be considered before total knee arthroplasty.For patient with DFSAA value more than 3°，anatomic-axis osteotomy is recommended；for patient with DFSAA value less than 3°，mechanical-axis osteotomy is recommended.

Key words： CT three dimensional reconstruction distal femoral sagittal anterior angle total knee arthroplasty

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