Türklerde diz eklem çizgisinin ölçümü

Year 2015, Volume: 49 Issue: 1, 41 - 44, 19.03.2015

Hulya Gurbuz Murat Cakar Mujdat Adas Ali Tekin Mehmet Bayraktar Cem Esenyel

https://doi.org/10.3944/AOTT.2015.14.0050

Abstract

Amaç: Total diz protezi özellikle de revizyon diz protezi sırasında eklem çizgisinin tespiti diz biyome¬kaniğinin sağlanması için çok önemlidir. Bu çalışmada, diz eklem çizgisinin yeri addüktör tüberkül ve fibula başına olan mesafeler ile tespit edilmeye çalışıldı.

Çalışma planı: Yüz sekiz hastanın 117 dizi çalışmaya dahil edildi. Anteroposterior diz grafisinde fe¬mur genişliği ile fibula başından eklem çizgisine olan mesafe ve addüktör tüberkülden eklem çizgisine olan mesafe ölçüldü.

Bulgular: Ortalama yaş 31.3 yıl (dağılım, 16-82 yıl) idi. Hastaların 63’ü erkek, 45’i kadın idi. Orta¬lama femur genişliği 87.2 mm ölçüldü. Addüktör tüberkül-eklem çizgisi mesafesi ortalama 47.9 mm, fibula başı-eklem çizgisi mesafesi ortalama 20.5 mm idi. Addüktör tüberkül –eklem çizgisi arası me¬safe ile femur genişliği arasında doğrusal bir korelasyon bulundu (oran 0.55). Fibula başı-eklem çizgisi arası mesafe ile femur genişliği arasında bir korelasyon tespit edilemedi.

Çıkarımlar: Çalışmamızda Türklerde daha önceki yayınlara benzer şekilde; yaş, cinsiyet, boy gibi fak¬törlerden etkilenmeyen femur genişliği ile addüktör tüberkül-eklem çizgisi mesafesi arasında doğrusal korelasyon bulundu. Bu yüzden eklem çizgisi seviyesini belirlemek için ameliyat esnasında dahi yerini rahatlıkla belirleyip ölçüm yapabileceğimiz, addüktör tüberkülü güvenilir bir belirteç olarak kullana¬biliriz.

Keywords

Diz eklem çizgisinin anatomik belirleyicileri; diz eklem çizgisi; revize diz protez cerrahisi; total diz protez cerrahisi

Measurement of the knee joint line in Turkish population

Abstract

Objective: The aim of the present study was to determine the knee joint line level by its distance to the adductor tubercle and the apex of the fibular head in the Turkish population.

Methods: The study included 117 knees of 108 patients (63 males, 45 females; mean age: 31.3 years, range: 16 to 82 years). Femoral width and the distance from the apex of the fibular head to the joint line as well as the distance from the adductor tubercle to the joint line were measured on anteroposterior radiographs.

Results: Mean femoral width was 87.2 mm. The average distance from the adductor tubercle to the joint line was 47.9 mm and from the fibular head to the joint line was 20.5 mm. A linear correlation was found between the distance from the adductor tubercle to the joint line and femoral width, with a ratio of 0.55. There was no significant correlation between the distance from the fibular head to the joint line and femoral width.

Conclusion: There was a linear correlation between the femoral width and the adductor tubercle-joint line distance irrespective of any factors such as age, gender and height. Therefore, the adductor tubercle can be used as a reliable landmark to determine the joint line level for easy evaluation and measurement during surgery.

Keywords

Anatomical determinants of the knee joint line, knee joint line, revision knee prosthesis surgery, total knee prosthesis surgery

References

• Laskin RS. Management of the patella during revision to- tal knee replacement arthroplasty. Orthop Clin North Am 1998;29:355-60.
• Laskin RS. Joint line position restoration during revi- sion total knee replacement. Clin Orthop Relat Res 2002;404:169-71.
• Iacono F, Lo Presti M, Bruni D, Raspugli GF, Bignozzi S, Sharma B, et al. The adductor tubercle: a reliable land- mark for analysing the level of the femorotibial joint line. Knee Surg Sports Traumatol Arthrosc 2013;21:2725-9.
• Servien E, Viskontas D, Giuffrè BM, Coolican MR, Park- er DA. Reliability of bony landmarks for restoration of the joint line in revision knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2008;16:263-9.
• Romero J, Seifert B, Reinhardt O, Ziegler O, Kessler O. A useful radiologic method for preoperative joint-line deter- mination in revision total knee arthroplasty. Clin Orthop Relat Res 2010;468:1279-83.
• Lustig S, Lavoie F, Selmi TA, Servien E, Neyret P. Re- lationship between the surgical epicondylar axis and the articular surface of the distal femur: an anatomic study. Knee Surg Sports Traumatol Arthrosc 2008;16:674-82.
• Havet E, Gabrion A, Leiber-Wackenheim F, Vernois J, Olory B, Mertl P. Radiological study of the knee joint line position measured from the fibular head and proximal tibial landmarks. Surg Radiol Anat 2007;29:285-9.
• König C, Sharenkov A, Matziolis G, Taylor WR, Perka C, Duda GN, et al. Joint line elevation in revision TKA leads to increased patellofemoral contact forces. J Orthop Res 2010;28:1-5.
• Sato T, Koga Y, Sobue T, Omori G, Tanabe Y, Sakamoto M. Quantitative 3-dimensional analysis of preoperative and postoperative joint lines in total knee arthroplasty: a new concept for evaluation of component alignment. J Ar- throplasty 2007;22:560-8.
• Howell SM, Chen J, Hull ML. Variability of the loca- tion of the tibial tubercle affects the rotational alignment of the tibial component in kinematically aligned total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2013;21:2288-95.
• Herzog RJ, Silliman JF, Hutton K, Rodkey WG, Stead- man JR. Measurements of the intercondylar notch by plain film radiography and magnetic resonance imaging. Am J Sports Med 1994;22:204-10.
• Sarmah SS, Patel S, Hossain FS, Haddad FS. The radio- logical assessment of total and unicompartmental knee replacements. J Bone Joint Surg Br 2012;94:1321-9.
• Lee IS, Choi JA, Kim TK, Han I, Lee JW, Kang HS. Reli- ability analysis of 16-MDCT in preoperative evaluation of total knee arthroplasty and comparison with intraoperative measurements. AJR Am J Roentgenol 2006;186:1778-82.
• Seedhom BB, Longton EB, Wright V, Dowson D. Di- mensions of the knee. Radiographic and autopsy study of sizes required by a knee prosthesis. Ann Rheum Dis 1972;31:54-8.