Correlation between femoral anatomical morphology and sagittal force line based on X-ray and CT three-dimensional reconstruction
Objective:To measure and analyze the anatomical parameters of the femur by measur-ing and analyzing the positive and lateral X-ray films of the full-length weight-bearing lower limbs and the three-dimensional model of the femur CT,and to clarify the correlation between the anatomi-cal morphology of the femur and the sagittal force line,so as to provide help for the placement of knee prosthesis and the accurate recovery of the lower limb force line in total knee arthroplasty.Methods:Ten healthy volunteers were recruited.The full-length X-ray films of the lower limbs were taken to determine the coronal and sagittal force lines of the lower limbs and the weight-bearing ratio.The im-aging data of 60 patients with full-length CTA of both lower limbs were collected.The CT data were reconstructed by Mimics software.The relevant anatomical parameters were measured by combining two-dimensional images and three-dimensional reconstruction models.The data were analyzed by K-S test.Results:(1 )The standard weight-bearing positive bearing axis is located at 45％ of the medial femoral condyle,and the lateral bearing axis is located at 44％before the transverse axis of the femoral condyle.(2)The femoral three-dimensional model measured femoral valgus angle,femoral lateral arch angle,femoral anterior arch angle,proximal femoral eccentricity,femoral neck anteversion,fem-oral neck shaft angle,and femoral length were 4.55°±1.31°,0.41°±1.44°,9.54°±1.57°,37.04 ±4.74 mm,14.99°±7.52°,131.17 ±7.23 °,and 414.24 ±23.70 mm,respectively;the angles between the femoral anatomical axis and the coronal and sagittal planes were 8.60 ±1.45,0.75 ± 0.60,1.05 ±0.70 and 0.61 ±0.50,respectively;the angles between the femoral force line and the coronal and sagittal planes were 1.38°±0.93°and 4.77°±1.65°,respectively.(3)Correlation anal-ysis showed that the femoral valgus angle was positively correlated with the femoral lateral arch angle (r=0.552,P＜0.001),the femoral valgus angle was positively correlated with the proximal femoral eccentricity (r=0.502,P＜0.001 ),and the femoral anterior arch angle was positively correlated with the femoral neck anteversion angle (r=0.543,P＜0.001);the angle between the femoral force line and the sagittal plane was positively correlated with the femoral anterior arch angle (r=0.823, P＜0.001),and the angle between the femoral force line and the sagittal plane was positively correla-ted with the femoral neck anteversion angle (r=0.424,P＜0.001).Conclusion:The angle between the femoral force line and the sagittal plane is closely related to the femoral anterior arch angle and the femoral neck anteversion angle.Therefore,if the femoral anterior arch angle and the femoral neck an-teversion angle are larger before operation,the osteotomy angle should be adjusted accordingly,which is conducive to achieving a more reasonable alignment of the force line.The correlation between the anatomical morphology of the femur and the sagittal alignment of the femur described in this study has important reference significance for the placement of knee prosthesis and total knee arthroplasty.
Total knee arthroplastySagittal force lineThree-dimensional modelingFemoral anatomy
万方数据
维普
