Imaging Measurement Of Anatomical Landmarks Of The Distal Femur On The Curative Effect Of Total Knee Arthroplasty

ObjectiveTo study the relationship between preoperative and postoperative imaging examination results of patients with knee osteoarthritis(OA)and the postoperative efficacy of total knee arthroplasty(TKA).MethodsCollected patients who underwent TKA in the First Affiliated Hospital of Zhengzhou University from December 2018 to October 2019.According to the inclusion and exclusion criteria,77 patients with knee OA(95 knees)were included in the study,and the patients all used the same type of prosthesis(U.S.Johnson&Johnson Attune),the operation was completed by the same surgeon,and the patients were followed up for 3 months and 6 months after the operation.The groups were divided into mild group(Grade Ⅲ and severe group(Grade Ⅳ)by Kellgren Lawrence classification.There were 59 knees in 48 people in the mild group,including 13 males with 15 knees,and 35 females with 44 knees,aged 51 to 79 years.,With an average age of 64.08±8.01 years,a body mass index of 25.1 to 34.8kg/m2,an average body mass index of 29.67±2.54kg/m2,a total of 36 knees in 29 people in the severe group,including 10 males with 11 knees and 19 females with 25 knees.6980 years old,average age 64.81±8.72 years old,body mass index 25.3 to 34.7kg/m2,average body mass index 30.31±2.64kg/m2.The preoperative and postoperative imaging data and clinical scoring data of the two groups were compared.The imaging data included posterior condyle angle,condyle torsion angle,femoral valgus angle,and lower limb force angle.Clinical scoring data included VAS score and HSS score.,WOMAC score,knee mobility.This study was designed as a retrospective study.The data was analyzed using SPSS 21.0 software.After the normality test was performed on the data,the quantitative data used t test.The categorical data was tested by χ2 test,and the correlation was analyzed by Pearson correlation.p<0.05 was statistically significant.ResultsThere was no significant difference in age,gender,body mass index,operation time,and follow-up time between the two groups of patients(p>0.05).The difference in posterior condyle angle,condyle torsion angle,and the angle of the lower limb force line between the two groups before and after operation was statistically significant(p<0.05).There was no significant difference in the preoperative femoral valgus angle between the two groups(p>0.05).The preoperative VAS score,HSS score and WOMAC score were not statistically significant between the two groups(p>0.05),and the difference in the range of motion of the knee joint between the two groups was statistically significant(p<0.05).Comparison of the postoperative posterior condyle angle and condyle torsion angle between the two groups was statistically significant(p<0.05).There was no significant difference in the postoperative femoral valgus angle and the angle of the lower limb force line between the two groups(p>0.05).There was no statistical significance in comparing the VAS score,HSS score,WOMAC score,and knee mobility between the two groups at 3 and 6 months after operation(p>0.05).Postoperative VAS score,WOMAC score and postoperative lower limb force line angle,preoperative and postoperative posterior condyle angle difference,preoperative and postoperative condyle torsion angle difference were positively correlated(p<0.05),postoperative HSS The score,the knee range of motion and the postoperative lower limb line of force angle,the preoperative and postoperative posterior condyle angle difference,and the preoperative and postoperative condyle torsion angle were all negatively correlated(p<0.05).The postoperative VAS score,HSS score,WOMAC score,and knee range of motion were not correlated with the preoperative and postoperative femoral valgus angle difference(p>0.05).Conclusion1.Knee joint OA patients’ lower limb force line and femoral external rotation anatomy have individualized differences,but the difference of femoral valgus is not significant.2.The preoperative imaging examination can guide the individualized osteotomy during TKA operation and obtain good curative effect.3.Compared with the imaging examinations before and after TKA,measuring the changes of femoral external rotation and the angle of the lower limbs can predict the patient’s early postoperative pain and functional recovery,and guide the patient’s prognosis.