中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (3): 570-576.doi: 10.12307/2025.909

• 骨与关节生物力学Bone and joint biomechanics • 上一篇    下一篇

单平面胫骨高位截骨：股腓角作为力线矫正的参考标志

李晓敏1，田向东2，王朝鲁1   

  1. 1 中国中医科学院望京医院，北京市 100102；2 北京中医药大学第三附属医院，北京市 100029
  • 收稿日期:2024-09-04 接受日期:2024-11-19 出版日期:2026-01-28 发布日期:2025-07-03
  • 通讯作者: 田向东，主任医师，博士生导师，北京中医药大学第三附属医院，北京市 100029 王朝鲁，主任医师，博士生导师，中国中医科学院望京医院，北京市 100102
  • 作者简介:李晓敏，男，1997年生，中国中医科学院在读博士，主要从事关节退行性改变的基础及临床研究。
  • 基金资助:
    北京中医药大学基本科研业务费项目(揭榜挂帅项目，2023-JYB-JBZD-026)，项目负责人：田向东；中国中医药信息学会科研项目(CACMS-KY-2023008)，项目负责人：王朝鲁

High tibial osteotomy on a single plane: femorofibular angle as a reference marker for mechanical axis correction

Li Xiaomin1, Tian Xiangdong2, Wang Chaolu1   

  1. 1Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China; 2Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China

  • Received:2024-09-04 Accepted:2024-11-19 Online:2026-01-28 Published:2025-07-03
  • Contact: Corresponding author: Tian Xiangdong, Chief physician, Doctoral supervisor, Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China Corresponding author: Wang Chaolu, Chief physician, Doctoral supervisor, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
  • About author:Li Xiaomin, Doctoral candidate, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
  • Supported by:
    Basic Research Business Expenses Project of Beijing University of Chinese Medicine, No. 2023-JYB-JBZD-026 (to TXD); Chinese Society of Traditional Chinese Medicine Information Research Project, No. CACMS-KY-2023008 (to WCL)

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摘要：

文题释义：

单平面胫骨高位截骨：是胫骨高位截骨的术式之一，由于截骨位置位于胫骨结节远端，对髌骨高度和髌股关节影响较小。
股腓角：是指股骨髁远端的连线和腓骨纵轴形成的夹角，单平面胫骨高位截骨术中股腓角在93°-95°的范围被认为是力线矫正到合理范围，该角度作为力线矫正的参考已经在临床上被广泛应用。

摘要
背景：股腓角是单平面胫骨高位截骨术中常用的力线矫正参考角度，但尚未有研究对该角度在单平面胫骨高位截骨术中的应用进行深入探究。
目的：探讨单平面胫骨高位截骨术中股腓角作为力线矫正参考的应用效果。
方法：回顾性分析2023年1月至2024年1月在北京中医药大学第三附属医院行单平面胫骨高位截骨的64例膝骨关节炎患者的病历资料，根据术中力线矫正参考方法分组：观察组32例，术中采用股腓角作为力线矫正参考；对照组32例，术中采用电刀线测量作为力线矫正参考。两组接受同样的围术期治疗和管理。记录术前及术后的下肢力线比率、髋膝踝角、胫骨近端内侧角及股腓角来评估两组患者下肢力学状态的变化；记录手术时间及透视次数；根据术前、术后1，3个月的疼痛目测类比评分及Lysholm评分来评估膝关节的疼痛和功能改变。
结果与结论：①所有患者均完成治疗和后续随访，未发生严重不良事件；②术前两组患者的下肢力线比率、胫骨近端内侧角、髋膝踝角及股腓角比较差异均无显著性意义(P > 0.05)；术后3个月两组患者的下肢力线比率、胫骨近端内侧角、髋膝踝角及股腓角均较术前显著改善，差异有显著性意义(P < 0.05)，两组之间比较均无显著差异(P > 0.05)；③术中观察组的手术时间和透视次数均少于对照组，差异有显著性意义(P < 0.05)；④术前及术后各随访节点，两组患者的疼痛目测类比评分及Lysholm评分比较差异均无显著性意义(P > 0.05)；术后随时间的改变，两组患者的疼痛目测类比评分及Lysholm评分均较术前显著改善(P < 0.05)；⑤提示单平面胫骨高位截骨术中应用股腓角作为力线矫正参考能够准确定位下肢力线矫正范围，简便可靠，较传统电刀线测量减少了透视次数及手术时间。

关键词: 单平面胫骨高位截骨, 膝骨关节炎, 股腓角, 力线矫正, 随访, 骨科植入物

Abstract: BACKGROUND: The femorofibular angle is a commonly used reference angle for mechanical axis correction in high tibial osteotomy on a single plane, but there has been no in-depth study on the application of this angle in high tibial osteotomy on a single plane. 
OBJECTIVE: To explore the application effect of the femorofibular angle as a reference for mechanical axis correction in high tibial osteotomy on a single plane. 
METHODS: A retrospective analysis was conducted on 64 cases of knee osteoarthritis patients who underwent high tibial osteotomy on a single plane at Third Affiliated Hospital of Beijing University of Chinese Medicine from January 2023 to January 2024. The patients were grouped according to the intraoperative mechanical axis correction reference method. The observation group consisted of 32 cases, which used the femorofibular angle as a reference for mechanical axis correction during surgery. The control group consisted of 32 cases, which used electrocautery line measurement as a reference for mechanical axis correction during surgery. Both groups received the same perioperative treatment and management. The lower limb mechanical axis ratio, hip-knee-ankle angle, proximal medial tibial angle, and femorofibular angle were recorded before and after surgery to assess changes in the lower limb mechanical state. The operation time and number of fluoroscopies were recorded. The visual analog scale score and Lysholm score for pain and knee function were recorded before surgery and at 1 and 3 months after surgery to evaluate changes in knee pain and function. 
RESULTS AND CONCLUSION: (1) All patients completed the treatment and follow-up, and no serious adverse events occurred. (2) Before surgery, there was no statistically significant difference in the lower limb mechanical axis ratio, proximal medial tibial angle, hip-knee-ankle angle, and femorofibular angle between the two groups (P > 0.05). At 3 months after surgery, the lower limb mechanical axis ratio, proximal medial tibial angle, hip-knee-ankle angle, and femorofibular angle were significantly improved in both groups compared to before surgery, with statistically significant differences (P < 0.05). There was no significant difference between the two groups (P > 0.05). (3) During surgery, the operation time and number of fluoroscopies in the observation group were less than those in the control group, with statistically significant differences (P < 0.05). (4) At each follow-up point before and after surgery, there was no statistically significant difference in the visual analog scale score and Lysholm score between the two groups (P > 0.05). With the passage of time after surgery, the visual analog scale score and Lysholm score in both groups were significantly improved compared to before surgery (P < 0.05). (5) It is suggested that the application of the femorofibular angle as a reference for mechanical axis correction in high tibial osteotomy on a single plane can accurately locate the range of lower limb mechanical axis correction, is simple and reliable, and reduces the number of fluoroscopies and operation time compared to traditional electrocautery line measurement.


Key words: high tibial osteotomy on a single plane, knee osteoarthritis, femorofibular angle, mechanical axis correction, follow-up, orthopedic implants

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