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目的观察膝关节股内侧肌髌骨止点形态与体表投影的关系,为全膝关节置换手术(TKA)股内侧肌下入路术前评估提供新思路。方法在20例下肢尸体标本上对股内侧肌髌骨止点形态的体表投影与解剖形态进行观测,同时对80侧健康成人下肢股内侧肌髌骨止点体表投影进行观测,比较3种情形下的股内侧肌止点在髌骨分布测量结果的差异。结果 55.0%(11例)的尸体标本股内侧肌止点长度与髌骨长度之比在40%～60%之间。股内侧肌髌骨止点长度与髌骨长度之比在尸体标本体表投影组、解剖测量组及健康成人下肢体表投影组分别为(47.8±15.1)%,(48.7±15.4)%及(46.7±14.8)%,3组测量值无统计学差异(P>0.05)。结论股内侧肌髌骨止点与髌骨长度之比的体表投影观察值与解剖后测量值差异不明显,术前股内侧肌髌骨止点体表投影评估对TKA手术入路的选择有参考价值。
Objective To observe the relationship between patellar abutment and medial projection of medial muscular knee joint, and to provide a new idea for the preoperative assessment of the medial submuscular approach in total knee replacement surgery (TKA). Methods Body surface projection and anatomy of medial patellofemoral condyle were observed on 20 corpse specimens of lower extremities. The projection of the patellar surface of lower extremity medullae muscle of 80 normal adults was observed. In three cases Differences in measured distributions of patellofemoral points in the medial femoral muscle. Results 55.0% (11 cases) of the cadaver specimens medial myocutaneous length and patellar length ratio of 40% to 60%. The ratio of patellar length to patellar length was (47.8 ± 15.1)%, (48.7 ± 15.4)% and (46.7 ±) respectively in the body surface projection group, anatomical measurement group and healthy adult lower limbs projection group 14.8)%, no significant difference was found between the three groups (P> 0.05). Conclusions There is no obvious difference between the projection of the medial patella and the patellar length on the medial side of the medial femur. The preoperative anatomical projection of the medial patellar patellar projection is of reference value for the choice of surgical approach to TKA.