| Objective:To investigate the changes of force line of lower extremity and its influence on the early function of knee joint after knee replacement,and to analyze how the changes of force line of knee joint inflence the force line of ankle joint on the operation side.It provides theoretical basis for correcting lower extremity line in clinical operation.Methods:We chose the patients who underwent TKA from November 2017 to March2019 in the first Department of bone,Affiliated Hospital of Zunyi Medical University as the study subjects.According to the inclusion criteria,89 patients(89 knees)were collected as the study group,There were 16 male patients(16 knees)and 73 female patients(73 knees).The average age was 63.2 years.The mean follow-up time was12-24(16.6±4.8)months.and 50 patients(50 knees)as the control group.Adobe Illustrator CC 2019 version 23.0 was used to measure on coronal plane and sagittal plane respectively.Coronal plane: according to the value of HKA before operation,the patients were divided into three groups: group A(-3 ° ? HKA ? 3 °),group B(-10 ° ? HKA <-3 ° or 3 ° < HKA ? 10 °),group C(HKA <-10 ° or HKA > 10 °).After comparing the general conditions of each group and determining the comparability between each group,The hip knee ankle angle(HKA),tibial talus angle(TTA),distal tibial lateral angle(LDTA),ground to tibial angle(GT),talus inclination angle(TT),tibial plateau to distal tibial angle(PP),ground to distal tibial angle(GP)were measured on the standard full-length orthopedic film.Sagittal position: on the standard lateral film of the whole length of the lower limb,the posterior inclination of the tibial plateau of the study group and the control group were measured with the anterior tibial cortex and the anatomical axis respectively.We measured the included angle ? ? between the tibial anatomical axis and the ankle joint,calculate the ratio of ? ? to ? ?,the ratio of ? ? to ? ? respectively.Analyze the influence of knee joint force line on ankle joint force line.At the same time,the knee HSS score and ROM were statistically processed,the early effect of TKA can be analyzed.Results:1.After operation,the changes of hip knee ankle angle(HKA)in group A were-0.5 ± 3.6 °,in group B were 1.3 ± 7.2 °,in group C were 11.2 ± 12.3 °,there were statistically significant differences among the three groups(P < 0.05),Among the change in group C was high,which was statistically significant compared with that in group A and B,while the change in group A and B was low,which was not statistically significant;the changes of ground tibia angle(GT)in group A were-2.0 ± 3.1 °,in group B were-2.2 ±4.9 °,in group C were-6.6 ± 5.7 °.There were statistically significant differences among the three groups(P < 0.05);The angle between the ground and the distal tibia(GP)was-2.0 ± 3.6 ° in group A,-2.6 ± 4.2 ° in group B,and-7.3 ± 5.9% in group C.There were significant differences among the three groups(P < 0.05);2.There was a negative correlation between the changes of HKA,GT and GP after TKA;3.There was significant difference(P < 0.05)between the study group ??/??and the normal group??/??.There was statistically significant difference(P < 0.05)between ?? / ? ? preoperative study group and normal group ??/??.There was no significant difference between the two postoperative groups(P > 0.05);4.There was significant difference in HSS score between the last follow-up after operation and before operation of 89 patients(P < 0.05);There was statistical difference in ROM in the last follow-up of preoperative and postoperative.Conclusion:1.After knee arthroplasty,the force line of ipsilateral ankle was changed,and the change of HKA grade was obvious;2.There was a negative correlation between the change of HKA and the improvement of GT and GP;3.Total knee arthroplasty can effectively improve the function of knee joint. |
PDF Full Text Request