新疆维吾尔族人群正常膝关节参数的CT测量及其临床意义

目的 探讨应用CT测量新疆维吾尔族人正常膝关节参数在膝关节假体设计中的临床价值。方法 根据纳入标准招募新疆维吾尔族成年志愿者100名进行前瞻性研究,男53名,女47名;年龄18~68岁,平均34.07岁。行膝关节伸直中立位CT扫描,扫描图像用AW4.4进行3D重建处理,抛币法选取左侧或右侧膝关节,分别测量记录髌骨厚度、胫骨平台内翻角(PT角)、小腿机械轴垂直线与双侧股骨髁远端切线的夹角(FT角),以及胫骨内侧平台最低点至腓骨头尖端高度的差距(DPF)等膝关节参数。将所得数据分别按男女组进行统计学处理,并将所得数值同文献报道的汉族人相关数据进行统计学比较。结果 新疆维吾尔族人正常膝关节髌骨厚度、PT角、FT角、DPF男性分别为(22.67±1.40)mm、4.64°±0.61°、4.85°±0.84°、(9.75±1.70)mm,女性分别为(20.70±1.41)mm、4.23°±0.55°、4.33°±0.58°、(8.13±1.80)mm,男性与女性之间的差异均有统计学意义(t值分别是7.006、3.512、3.543、4.634,P值均<0.01)。与相关文献报道的汉族人群相比,维吾尔族正常膝关节髌骨厚度、PT角、FT角之间的差异均无统计学意义(t值分别是1.056、0.844、0.572,P值均>0.05),DPF之间的差异有统计学意义(t=3.996,P<0.01)。结论 对新疆维吾尔族人进行全膝关节置换术,包括髌骨置换术等操作时,为确保操作精确性,不能直接参考其他人群相关数据;设计国人膝关节假体时应该考虑到不同人群及性别的差异。

Measurement of normal knee parameter of uyghur people living in Xinjiang and its clinical significance

Objective To measure normal knee parameter of Uyghur people living in XinJiang and investigate its clinical significance in the design of total knee arthroplasty prosthesis.Methods One hundred volunteers were recruited according to the inclusion criteria. CT scan was performed in 100 knees (left or right knee was selected randomly) of Uyghur (53 males and 47 females, range 18-68 years old, average 34.07 years old). The patellar thickness, angle tibial platean-tibial shaft(PT), angle femoro-tibial(FT), and distance of tibial plateau to fibular head (DPF) were measured by 3-D morphology reconstructed with AW4.4. The values were statistically analyzed based on gender compared with Chinese data.Results The normal knee parameter of Uyghur were: patellar thickness male:(22.67±1.40) mm, female:(20.70±1.41) mm, t=7.006)], angle PT (male: 4.64°±0.61°, female: 4.23°±0.55°, t=3.512), angle FT (male: 4.85°±0.84°, female: 4.33°±0.58°, t=3.543), DPFmale:(9.75±1.70) mm, female:(8.13±1.80) mm, t=4.634]. There were significant differences between male and female for all the above four parameters(all P values<0.01). There were no differences between Uyghur and Chinese for the above parameters(the t values were 1.056, 0.844, and 0.572,respectively, all P values＞0.05).Coclusions During total knee arthroplasty, including patellar replacement for Uyghur, for ensure the operation accuracy, it should not directly refer other race related parameter. The race and sex difference should be taken into account when designing domestic knee joint prosthesis.