| 算数髋膝踝角与膝关节单髁置换术患者下肢固有力线的关系研究 |
| The study on the relationship between the arithmetic hip-knee-ankle angle and constitutional alignment of the lower limb in patients undergoing unicompartmental knee arthroplasty |
| 投稿时间：2024-09-20 |
| DOI：10.3969/j.issn.1672-5972.2025.02.001 |
| 中文关键词: 算数髋膝踝角 膝关节单髁置换术 膝骨关节炎 固有力线 影像学测量 |
| 英文关键词:Arithmetic hip-knee-ankle angle(aHKA) Unicompartmental knee arthroplasty (UKA) Knee osteoarthritis (KOA) Constitutional alignment Radiographic measurement |
| 基金项目:深圳市科技创新委员会可持续发展专项（KCXFZ20230731093059012）；深圳市第二人民医院高水平医院医疗安全质控及提升项目（202204015） |
| 作者 | 单位 | 邮编 | | 柳昌全* | 深圳市第二人民医院(深圳大学第一附属医院)骨关节骨肿瘤科,广东 深圳,518035 | 518035 | | 孙炜* | 深圳市第二人民医院(深圳大学第一附属医院)骨关节骨肿瘤科,广东 深圳,518035 | 518035 | | 尤微 | 深圳市第二人民医院(深圳大学第一附属医院)骨关节骨肿瘤科,广东 深圳,518035 | 518035 | | 谢伟 | 深圳市第二人民医院(深圳大学第一附属医院)骨关节骨肿瘤科,广东 深圳,518035 | 518035 | | 谭纪锋 | 深圳市第二人民医院(深圳大学第一附属医院)骨关节骨肿瘤科,广东 深圳,518035 | 518035 | | 黄诚 | 中日友好医院骨科关节外科,北京,100029 | 100029 | | 张启栋 | 中日友好医院骨科关节外科,北京,100029 | 100029 | | 郭万首 | 中日友好医院骨科关节外科,北京,100029 | 100029 |
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| 中文摘要: |
| 目的 描述和验证算数髋膝踝角（arithmetic hip-knee-ankle angle, aHKA）用于预测膝骨关节炎（knee osteoarthritis, KOA）下肢的固有力线（骨关节炎前力线）在国人膝关节内侧单髁置换术（unicompartmental knee arthroplasty, UKA）患者中的适用性。方法 本研究纳入2019年5月至2022年5月在中日友好医院接受内侧UKA的69例患者（非手术侧膝关节正常）。在负重位双下肢全长X线片上进行影像学参数的测量，包括股骨远端外侧角（mechanical distal lateral femoral angle, LDFA）、胫骨近端内侧角（mechanical medial proximal tibial angle, MPTA）和髋膝踝角（hip-knee-ankle angle, HKA），aHKA定义为180°-LDFA+MPTA。研究结局包括比较UKA患者中KOA下肢的aHKA和正常膝关节下肢的HKA之间的差异，以及评估两者之间的相关性和一致性。结果 UKA患者中KOA下肢的aHKA（177.90°±1.96°）和正常膝关节下肢的HKA（178.08±1.98°）之间比较，差异无统计学意义（P=0.357），两者之间具有强相关性（r=0.741，P＜0.001）和良好的一致性［Altmann图中97.1%的数据位于95%一致性界限（95% limit of agreement， 95% LOA）内］。结论 本研究初步验证了aHKA能够反映国人UKA患者中KOA下肢的固有力线，该指标可以用于UKA在下肢力线方面的术前规划。 |
| 英文摘要: |
| Objective To describe and validate the applicability of arithmetic hip-knee-ankle angle (aHKA) for predicting the constitutional alignment (pre-arthritic alignment) of the lower limb in Chinese patients with knee osteoarthritis (KOA) who underwent medial unicompartmental knee arthroplasty (UKA).Methods This study enrolled 69 patients who underwent medial UKA (normal knee on the non-surgical side) at the China-Japan Friendship Hospital from May 2019 to May 2022. Radiographic parameters, including the mechanical distal lateral femoral angle (LDFA), the mechanical medial proximal tibial angle (MPTA), and the hip-knee-ankle angle (HKA), were measured on weight-bearing full-length radiographs, and aHKA was defined as 180°-LDFA+MPTA. Outcomes included comparison of the aHKA of lower limbs affected by KOA with the HKA of lower limbs with normal knee joints, as well as assessing the correlation and consistency between the two.Results There was no statistically significant difference between the aHKA (177.90°±1.96°) of the lower limbs with KOA and the HKA (178.08°±1.98°) of normal knee joints (P=0.357) in patients who underwent UKA, but there was a strong correlation (r=0.741, P<0.001) and good agreement (97.1% of the data in the Altmann plot were at the 95% limit of agreement, 95% LOA) between the two.Conclusion This study provides preliminary evidence that aHKA may reflect the constitutional alignment of the lower limb in Chinese patients with KOA who underwent UKA. This parameter can be used for preoperative planning of the lower limb alignment in UKA. |
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