The Study Of The Correlation Between "femur And Fibular Angle" And Lower Limb Force Line In High Tibial Osteotomy

Research purposes:1.the effective correction of lower limb power line is the key in treatment of knee osteoarthritis,this research is that the tibia bone is osteotomied by a standard of the femoral fibular angle 93°,scientifically observes the correction of lower limb line,and provide theoretical reference basis for effectively positioning lower limb power line.2.To observe the effect of body mass index on positioning of lower limb line at femoral fibular angle in high tibial osteotomy.Methods:According to inclusion criteria and exclusion criteria,64 cases of knees were finally obtained.There are 21 male and 43 female.The age of them is from 45 to 65(55.8±13.6);Height and weight of the patients were measured in the way of 0.5 cm and 0.5 kg,respectively.Body mass Index(BMI)is calculated by dividing body mass(kg)by height(m)squared.According to the adult body mass index classification standard established in China,inclusion criteria and exclusion criteria of this study,64 knees were divided into 3 groups:normal group,BMI<24.0,a total of 21 knees;Super-recombination,24.0 BMI<28.0,total 23 knees;Obese group,28.0 BMI<31.0,total 20 knees.Preoperative bone cutting and high tibial osteotomy is in "phil Angle 93°" positioning line of force of lower limb,and 1 month after’surgery and follow-up at the end of time.In the Simulated osteotomy and the high tibial osteotomy,a full-length films of lower limb force line in weight-bearing position is taken before and after surgery,and CAD-2010(computer-aided design-2010)was used to measure femoral fibular Angle hip knee ankle Angle and lower limb mechanical force line,respectively.The results:All the preoperative lower limb full-length films were simulated osteotomy;All patients were followed up after the high tibial osteotomy from 6 months to 8 months respectively.1.Simulated osteotomy:(1)there was a significant difference between the simulated hip knee ankle angles before and after osteotomy,with a statistically significant difference of 167.38±2.63 before osteotomy and 183.73±0.56 after osteotomy(P<0.05).The mechanical line before and after simulated osteotomy were significantly different,with an average of 31.69±0.69%after simulated osteotomy and 65.32±1.77 after simulated osteotomy(P<0.05).There were statistically significant differences after simulated osteotomy.2.The high tibial osteotomy:(1)the study found that the full-length X-ray lower limb strength line in postoperative standing position was well corrected.Hip-knee-ankle Angle by preoperative 170.78 ± 3.49°,to a month after 183.36 ±1.03 ° and the last follow-up of 182.53 ±1.34°.Preoperative and postoperative differences were significant,with statistical significance(F=116.010,p=0.000(p<0.05)).The mechanical force lines of the lower limbs were distributed on the tibial plateau from 31.032.42%before surgery to 64.322.83%one month after surgery and 62.36 3.72%at the last follow-up.The difference between preoperative and postoperative was significant(F=116.010,p=0.000(p<0.05)).(2)patients were divided into normal group,super-recombinant group and obese group according to body index,and further study found that.in the preoperative comparison between the normal group and the super-recombination group,there was no significant difference in the position of femoral peroneal Angle,hip knee ankle Angle and the mechanical line.However,there were significant differences between the normal group and the obese group.The femoral peroneal Angle,hip knee ankle Angle and the line of the obese group were all smaller than those in the normal group,one month after the operation and the last follow-up visit,the femoral peroneal Angle of the normal group was 92.33±0.48 and 91.60±0.49,respectively,and that of the obesity group was 90.13±1.12 and 89.46±1.12,respectively.Correspondingly,the hip ankle Angle and the mechanical line of the obesity group one month after surgery and the last follow-up were also smaller than those in the normal group.The hip knee ankle Angle of the obesity group one month after surgery and the last follow-up were 182.14±1.1.01 and 180.69±0.92 respectively,while those in the normal group were 183.94±0.61 and 183.40±0.74 respectively.In the obesity group,the position of the lower limb force line at the tibial plateau one month after surgery and the last follow-up were 61.24±3.31 and 58.00±4.76,respectively,while in the normal group,it was 65.75±1.45 and 64.29±1.39,respectively.Research conclusions:1."the femoral fibular angle 93°" in the high tibial osteotomy,whether normal,overweight or obesity in the group can effectively accurate of the lower limb power line;2."the femoral fibular angle 93°" is applied for locating in Lower limb power line in high tibial osteotomy,only taking the knee joint can effectively judge the correct degree of the lower limb power line.It changed the past way which must be respectively taken the joint of hip、knee and ankle to determine the lower limb power line;3.The"the femoral fibular angle 93°" effectively positioning lower limb power line in obese group was obviously lower than normal group and the overweight.So the body fat of patients must be considered in the preoperative design scheme,when the femoral fibular angle is applied for locating the lower limb power lines in high tibial osteotomy.In addition,when the obese will be implied by the high tibia bone,we suggest that t "the femoral fibular angle 94°" or“the femoral fibular angle 95°" is likely to more accuratly correcte the lower limb power line than“the femoral fibular angle 93°".