膝关节相关解剖结构测量在全膝关节置换术假体选择中的应用

目的测量股骨、胫骨、髌骨的相关结构数据并归纳总结其特点,为研发符合我国人群的膝关节假体提供数据支持。方法对正常膝关节标本中股骨髁上轴宽度、股骨后髁轴距等16项指标进行测量,分析股骨内侧髁前后径、股骨外侧髁前后径等指标与胫骨平台宽度的相关性。结果共测得24例成人正常膝关节胫骨平台宽度为(70.63±7.27)mm。相关分析结果显示,股骨内侧髁前后径与胫骨平台宽度相关系数为0.747,股骨外侧髁前后径与胫骨平台宽度相关系数为0.634,胫骨内侧平台宽度与胫骨平台宽度相关系数为0.729,胫骨外侧平台宽度与胫骨平台宽度相关系数为0.899,胫骨内侧平台前后径与胫骨平台宽度相关系数为0.809,胫骨外侧平台前后径与胫骨平台宽度相关系数为0.651,髌骨宽度与胫骨平台宽度相关系数为0.701。胫骨内侧平台、胫骨外侧平台及股骨髁上轴宽度对胫骨平台宽度有明显影响(F=226.072,P<0.001)。结论股骨髁上轴宽度对胫骨平台宽度有影响,股骨内、外侧髁前后径、髌骨宽度与胫骨平台宽度呈正相关。通过他们之间的相关性有望对临床膝关节置换术假体选择等手术决策提供一定的参考。

Application of knee related anatomical structure measurement in prosthesis selection for total knee replacement

Objective To provide data support for the research and development of knee prosthesis in line with the Chinese population by measuring the relevant structural data of femur,tibia and patella and summarizing their characteristics.Methods Sixteen indexes such as the width of the femoral supracondylar axis and the axial distance of the posterior femoral condyle were measured in normal knee specimens to analyze the correlation between tibial plateau width and anteroposterior diameter of medial femoral condyle and anteroposterior diameter of lateral femoral condyle was analyzed.Results The tibial plateau width of 24 adult normal knee joints was(70.63±7.27)mm.The correlation analysis showed that the correlation coefficient of the anteroposterior diameter of medial femoral condyle and tibial plateau width was 0.747;the correlation coefficient of the anteroposterior diameter of lateral femoral condyle and tibial plateau width was 0.634;the correlation coefficient of the width of medial tibial plateau and tibial plateau width was 0.729;the correlation coefficient of the width of lateral tibial plateau and tibial plateau width was 0.899;the correlation coefficient of the anteroposterior diameter of medial tibial plateau and tibial plateau width was 0.809;the correlation coefficient of the anteroposterior diameter of lateral tibial plateau and tibial plateau width was 0.651;the correlation coefficient of the the width of patella and tibial plateau width was 0.701.The widths of medial tibial plateau,lateral tibial plateau,and femoral supracondylar axis have obvious influence on the width of tibial plateau(F=226.072,P<0.001).Conclusion The width of the femoral supracondylar axis have effects on the width of the tibial plateau.The anteroposterior diameter of the medial and lateral femoral condyle and the width of the patella are positively correlated with the width of the tibial plateau.The correlation between the relevant structural data of femur is expected to provide some reference for clinical knee arthroplasty prosthesis selection and other surgical decisions.