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中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (07) : 552 -555. doi: 10.3877/cma.j.issn.1674-0785.2021.07.014

综述

外翻膝患者全膝关节置换术中股骨远端外翻截骨应用的研究进展
齐岩松1, 吴海贺1, 徐永胜1,†(), 王一帆1   
  1. 1. 010017　呼和浩特，内蒙古自治区人民医院骨关节科（运动医学中心）
  • 收稿日期:2021-05-01 出版日期:2021-07-15
  • 通信作者: 徐永胜
  • 基金资助:
    内蒙古自治区科技计划项目(201802154，2021GG0127)

Application of distal femoral valgus osteotomy in total knee arthroplasty in patients with valgus knee

Yansong Qi1, Haihe Wu1, Yongsheng Xu1,†(), Yifan Wang1   

  1. 1. Department of Orthopedics (Sports Medicine Center), People's Hospital of Inner Mongolia Autonomous Region, Hohhot 010017, China
  • Received:2021-05-01 Published:2021-07-15
  • Corresponding author: Yongsheng Xu
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齐岩松, 吴海贺, 徐永胜, 王一帆. 外翻膝患者全膝关节置换术中股骨远端外翻截骨应用的研究进展[J]. 中华临床医师杂志(电子版), 2021, 15(07): 552-555.

Yansong Qi, Haihe Wu, Yongsheng Xu, Yifan Wang. Application of distal femoral valgus osteotomy in total knee arthroplasty in patients with valgus knee[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(07): 552-555.

人工全膝关节置换术（TKA）已成为晚期膝骨关节疾病常见的治疗方法，恢复下肢力线是TKA手术成功的关键之一。外翻膝主要是由于骨性结构的改变以及外侧软组织紧张或者内侧软组织松弛、损伤而导致的。相较于内翻而言，外翻膝在临床上更为少见，但随着TKA术后效果不断优化，临床上复杂外翻膝逐渐增多。股骨远端外翻截骨通过改变异常骨性结构从而纠正下肢力线，是TKA成功的关键因素之一。但对于不同类型的外翻分型，选择何种合适的截骨角度仍是存在争议的问题。本文通过查阅近年来相关文献，分别从解剖及生物力学、分型及治疗等方面对股骨远端外翻截骨在TKA中的应用进展做一综述。

关键词: 骨性关节炎, 外翻膝, 全膝关节置换术, 外翻截骨

Total knee arthroplasty (TKA) has become a common treatment for advanced knee joint diseases. Restoring lower limb power line is one of the keys to the success of TKA surgery. Knee valgus is mainly caused by changes in bony structure and lateral soft tissue tension or medial soft tissue relaxation or injury. Valgus knee is clinically less common than varus knee. However, with the continuous optimization of postoperative results after TKA, the number of complex valgus knees in clinical practice is increasing. Distal femoral valgus osteotomy is a key factor for the success of TKA by correcting the lower limb power line by altering the abnormal bony structure. However, for different types of valgus classification, it is still controversial to choose the appropriate osteotomy angle. This article reviews the application of distal femoral valgus osteotomy in total knee arthroplasty from the aspects of anatomy, biomechanics, classification, and treatment by referring to the relevant literature in recent years.

Key words: Osteoarthritis, Valgus knee, Total knee arthroplasty, Valgus osteotomy
表1 北京积水潭医院外翻膝分型
分型 畸形来源 DCA PCA 膝关节伸直位 膝关节屈曲位
F1a 股骨关节内 ↑ - 外翻 不外翻
F1b 股骨关节外 - - 外翻 不外翻
F2 股骨关节内 ↑ ↑ 外翻 外翻
T1 胫骨关节内 - - 外翻 外翻
T2 胫骨关节外 - - 外翻 外翻
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