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슬관절 전치환술 후 대퇴 치환물의 회전각 및 슬개골 경사각과 임상 결과의 상관관계

The Correlation of Postoperative Femoral Component Rotation Angle and Patella Tilt Angle with Clinical Results in Total Knee Arthroplasty

경희수|Sang-Ho Cheon|Jae-Wook Jung
대한슬관절학회 (Korean Knee Society)|2011.06|Knee Surgery and Related Research|제23권 제2호|pp. 96-103

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Total knee arthroplasty슬관절 전치환술대퇴 치환물의 회전각슬개골 경사각Femoral component rotation anglePatella tilt angle

초록

목적: 슬관절 전치환술 후 대퇴 치환물의 회전각 및 슬개골 경사각과 임상 결과와의 연관성에 대해 분석하고자 하였다. 대상 및 방법: 2002년 3월부터 2010년 2월까지 양측 슬관절 전치환술을 시행한 환자 48명, 96예를 대상으로 하였다. 대퇴 치환물의 회전각 및 슬개골 경사각은 컴퓨터단층촬영을 이용하여 측정하였으며, 임상 결과는 미국 슬관절 학회의 슬관절 점수 및 기능 점수와 Feller의 슬개골 점수로 평가하였다. 대퇴 치환물의 회전각, 슬개골 경사각과 임상 결과 간의 상관 관계를 분석하였고, 부가적으로 PFC^Ⓡ Sigma 군과 Scorpio NRG^Ⓡ군, 슬개-대퇴 증상군과 비증상군 사이를 비교하였다. 결과: 대퇴 치환물의 회전각은 평균 1.40^o 내회전, 슬개골 경사각은 평균 3.79^o 외측 경사였다. 그리고 슬관절 점수는 평균 90.5점, 기능 점수는 평균 77.4점, 슬개골 점수는 평균 23.9점이었다. 대퇴 치환물의 회전각과 슬관절 점수 사이에 유의한 상관관계가 있었고(p=0.031, r=−0.284), 기능 점수 및 슬개골 점수 와의 상관관계는 유의하지 않았다. 슬개골 경사각과 임상 결과들 사이의 상관관계는 유의하지 않았다. 대퇴 치환물의 회전각은 PFC^Ⓡ Sigma 군에서 평균 2.00^o 내회전, Scorpio NRG^Ⓡ 군에서 평균 0.81^o 내회전이었으며, 양 군 간에 유의한 차이가 있었으나(p=0.004), 임상 결과에서는 차이가 없었다. 슬개-대퇴 증상군과 비증상군을 비교할 때 대퇴 치환물의 평균 회전각은 증상이 있는 군에서 전체 평균보다 좀 더 벗어나는 값을 보였다결론: 슬관절 전치환술 시 술 후 대퇴 치환물의 회전각이 내회전될수록 낮은 슬관절 점수를 보였다. 그러나 슬개골 경사각과 임상 결과들 사이의 상관관계는 유의하지 않았다.

Abstract

Purpose: The aim of this study was to analyze the correlation of postoperative femoral component rotation angle and patella tilt angle with clinical results for total knee arthroplasty. Materials and Methods: Ninety-six cases in 48 patients who underwent total knee arthroplasty between March 2002 and February 2010 were enrolled. Femoral component rotation angle (FRA) and patella tilt angle (PTA) were measured with postoperative computed tomography. Clinical results were evaluated using American Knee Society knee score & function score and Feller's patella score. We analyzed the correlation of FRA and PTA with clinical outcomes. We also compared clinical results between the PFC^Ⓡ Sigma group and the Scorpio NRG^Ⓡ group, and the patello-femoral symptom group and a symptom-free group. Results: The mean FRA was 1.40^o of internal rotation. The patellar tilt angle was 3.79^o of lateral tilt. The mean knee score was 90.5, the function score was 77.4, and the patella score was 23.9. There was a significant difference between FRA and knee scores (p=0.031, r=−0.284). There were no significant differences between FRA and function score or patella score. The correlation of PTA and clinical results was not significant. The mean FRA was 2.00^o of internal rotation in the PFC^Ⓡ Sigma group, and it was significantly different than for the Scorpio NRG^Ⓡ group which had 0.81^o of internal rotation; but there were no significant differences between the two groups in clinical results. The patello-femoral symptom group deviated more from the mean FRA than did the symptom-free group. Conclusion: Internal rotation of the femoral component is correlated with poor clinical results after total knee arthroplasty. The correlation of patella tilt angle and clinical results was not significant.

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