股骨远端解剖数据测量及其与膝关节假体径线的匹配性探讨

目的　将股骨远端解剖结构相关数据与国内常用的膝关节假体参数进行对比，评估假体吻合度，为设计符合解剖结构的假体提供参考。 方法　①选100例无明显骨质缺损的华南地区成人股骨标本 (左51，右49), 拍数字化照片；②校正放大率后测量：机械轴长度、机械轴/解剖轴夹角、髁横径、髁间截骨面横径、外髁前后径、内髁前后径；③测量Zimmer NexGen LPS、Stryker Scrorpio NRG Knee-Flexed、United-U1、威高 GKPS假体的髁内外径宽、假体前髁高度及后髁高度。 结果　(1)股骨远端横径为(7.60±0.60) cm，股骨远端外侧髁高度为(5.90±0.76) cm，内侧髁高度为(5.73±0.74) cm，其间无明显相关性；(2) 4品牌假体的截骨长度均可适应股骨远端骨结构，但前髁截骨高度与4种品牌假体前髁高度对比，在设定容差范围内的涵盖率为24%~55%，股骨后髁高度与假体的后髁高度对比，涵盖率仅14%~21%。 结论　股骨远端解剖形态数据分布较为弥散，在关节置换过程中需个体化处理。假体径线与华南地区国人股骨远端形态存在一定差异。

Comparison between the morphology of Chinese people’s distal femurs and the parameters of knee joint prostheses

Objective　In the present study we compared the morphological parameters of distal femurs with the relevant parameters of knee prostheses, intending to obtain data for better-fit prosthesis design.　Methods　(1) One hundred adult femur samples from South China (left 51, right 49) with no evident bony defect are selected and photographed. (2) The magnification is corrected according to the photographed scale. Data of measured femoral mechanical axis lengths, angles between mechanical axis/anatomical axis, transverse diameters of the condyles, transverse diameters of distal condylar osteotomic surfaces, anteroposterior diameters of the medial and lateral condyles were obtained. (3) Meanwhile, the widths between the internal and external condylar, heights of the anterior and posterior condyles of the prostheses (both domestic and imported including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, United-U1 and GKPS) were measured.　Results　(1) The average distal femoral transverse diameter was (7.60±0.60) cm; the average height of the lateral condyles was (5.90±0.76) cm; the average height of the medial condyles was (5.73±0.74) cm. No evident relativity existed e between these data. (2)The osteotomic lengths of the prostheses from all four brands fitted Chinese people’s distal femur. By comparing the ostotomic heights of anterior condyles and the heights of anterior prosthetic condyle, a coverage rate of 14%~21% was obtained which fell within the range of tolerance. Similarly, we got a coverage rate of only 24%~55% posteriorly.　Conclusions　Since the morphological data of Chinese people’s distal femur are dispersive, individualized replacement is required. The parameters of prostheses do not completely match the morphology of distal fumurs of Chinese people.