全膝关节置换术后踝疼痛与下肢影像学参数的关系

Relationship between ankle pain and lower extremity imaging parameters after total knee arthroplasty

摘要:

[目的] 探究全膝关节置换术后患者踝疼痛与下肢影像学参数的关系。[方法] 2023 年9 月—2024 年2 月，膝关节骨性关节炎行初次TKA 的41 例患者纳入本研究。观察术后6 个月踝疼痛的发生情况，测量下肢影像参数，分析是否踝疼痛与影像参数的关系。[结果] 41 例患者中，术后6 个月出现踝关节疼痛13 例，占31.7%；无踝关节疼痛28 例，占68.3%。术前，疼痛组HKA、TAA、TTA 和TI 显著大于无疼痛组（P＜0.05）；术后6 个月，疼痛组TAA、TTA、TI 和mLDTA 显著大于无痛组患者（P＜0.05）。两组间术前及术后6 个月的ADTA 和HAA 的差异均无统计学意义（P＞0.05）。ROC 分析结果表明，?HKA 和?mLDTA 预测术后踝关节疼痛的的曲线下面积（area under cure, AUC） 值分别为0.893 和0.955。[结论] 膝关节内翻纠正过大及踝关节代偿不足，可能与膝关节置换术后患者踝关节疼痛有关。

Abstract:

[Objective] To explore the relationship between ankle pain and imaging parameters of lower extremity after total knee ar-throplasty. [Methods] From September 2023 to February 2024, 41 patients who underwent primary TKA for knee osteoarthritis were en-rolled in this study. The incidence of ankle pain 6 months after operation was observed, the imaging parameters of lower limbs were mea-sured, and the relationship between ankle pain and imaging parameters was analyzed. [Results] Of the 41 patients, 13 (31.7%) had anklejoint pain 6 months after operation, whereas other 28 (68.3%) had no ankle pain. The pain group proved significantly greater HKA, TAA,TTA and TI than the painless group before surgery (P＜0.05), significantly greater TAA, TTA, TI and mLDTA than the painless group 6months postoperatively (P＜0.05). However, there were no significant differences in ADTA and HAA between the two groups before opera-tion and 6 months after surgery (P＞0.05). As results of ROC analysis, the area under curve (AUC) of ?HKA and ?mLDTA were 0.893 and0.955 in predicting postoperative ankle pain respectively. [Conclusion] Over-corrected knee varus and under-compensated ankle may berelated to ankle pain after total knee arthroplasty.