股骨远端后髁角的数字化三维重建与测量

目的 探讨股骨远端后髁角个性化、数字化测量方法,为全膝关节置换术时截骨旋转对线提供解剖学依据. 方法 对32名正常人双侧膝关节行CT扫描,应用Mimics10.0软件,利用数字化三维重建技术重建股骨远端,标定后髁角的解剖标志,测量股骨远端后髁角. 结果 男36膝,股骨远端后髁角:左侧4.33°±0.67°,右侧4.45°±0.72°,平均4.39°±0.69°;女28膝,股骨远端后髁角:左侧4.45°±0.73°,右侧4.68°±0.37°,平均4.57°±0.58°;股骨远端后髁角总平均值:4.46°±0.54°,不同性别间及左右两侧股骨远端后髁角比较,差异无统计学意义. 结论 基于CT影像的股骨远端数字化三维重建影像具有良好的形态和较清晰的边界,可精确识别后髁角的解剖标志并进行三维测量,能较好地为国人膝关节假体的设计提供解剖数据,同时也为个性化的全膝关节置换术提供了方法.

Three-dimensional digital reconstruction and measurement of posterior condylar angle of distal femur

Objective To explore digital measurement of the posterior condylar angle (PCA) on three-dimensional reconstruction of CT images of the normal adult distal femur, because it may provide rea-sonable parameters for the rotational alignment in the total knee arthroplasty. Methods CT scanning of bilateral knees was conducted for 32 normal adults (18 males and 14 females) . Three-dimensional recon-struction of distal femur was performed using Mimics10.0 software on the basis of the CT data. The bony landmarks determining PCA were made on the three-dimensional images of the normal distal femur. PCA was measured across lateral and medial femoral epicondyli on the three-dimensional images. Results In the 36 male knees, the left side PCA averaged 4.33°± 0. 67° and the right side 4.45°±0.72° (mean, 4.39°±0. 69°). In the 28 female knees, the left side PCA averaged 4.45°± 0. 73° and the right side 4.68°± 0. 37°(mean, 4. 57°±0. 58°) . There was no statistically significant difference in gender or side. Conclusions It is feasible to accurately identify the bony landmarks determining PCA on the three-dimensional recon-struction of the distal femur. Digital measurement of PCA can provide reasonable parameters for rotational alignment in the total knee arthroplasty. It can also be useful in the design of femoral prosthesis.