大骨节病膝关节股骨远端解剖形态数字学研究及其意义
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摘要
目的:通过CT测量适合行全膝关节置换术(total knee arthroplasty,TKA)的大骨节病膝关节股骨远端解剖参数,为行TKA的大骨节病股骨假体的设计提供参考依据。方法:选取适合TKA的大骨节病和骨性关节炎患者进行膝关节CT扫描,用Mimics软件进行三维重建并测量股骨内外径(femoral mediolateral,ML)、股骨外侧髁前后径(lateral anteroposterior,LAP)、股骨内侧髁前后径(medial anteroposterior,MAP)、股骨内侧髁宽(medialcondylar width,MCW)、股骨外侧髁宽(lateral condylar width,LCW),并计算ML/LAP比值,比较股骨远端各解剖形态参数差异。结果:大骨节病组股骨远端各解剖数据测量值(ML、MAP、LAP、MCW、MCW)均小于骨性关节炎组,差异有统计学意义(P <0.01)。大骨节病股骨远端ML/LAP比值明显大于骨性关节炎组,显示一个给定LAP的股骨假体,大骨节病股骨远端ML有可能会覆盖不全,骨性关节炎有可能会悬空。结论:大骨节病膝关节股骨远端解剖形态与骨性关节炎存在一定差异,为设计适合大骨节病的TKA人工股骨假体提供理论依据。
Objective: To measure and analyze anatomic parameter of distal femur in Kaschin-Beck disease(KBD) patients which candidate for total knee arthroplasty(TKA). Method:95 knees(46 KBD, 49 OA) were measured by CT for the distal femoral mediolateral(ML), lateral anteroposterior(LAP), medial anteroposterior(MAP), medial condylar width(MCW), lateral condylar width(LCW) and ML/LAP aspect ratio to compared the morphometric differences of distal femur between KBD and OA knees.Result: There were significant differences between KBD and OA knees in relation to ML, LAP, MAP, MCW and LCW dimensions(P <0.01). We also found that KBD have larger ML/LAP aspect ratio than that of OA knees under a given LAP dimension. This means that under a given LAP dimension component, the femoral ML dimension tended to undersized in KBD and overhang in OA knees.Conclusion: Distal femoral anatomy showed significant differences in the size and shape between KBD and OA knees, which provide vital theoretical basis for designing proper femoral prosthesis for KBD patients.
Objective: To measure and analyze anatomic parameter of distal femur in Kaschin-Beck disease(KBD) patients which candidate for total knee arthroplasty(TKA). Method:95 knees(46 KBD, 49 OA) were measured by CT for the distal femoral mediolateral(ML), lateral anteroposterior(LAP), medial anteroposterior(MAP), medial condylar width(MCW), lateral condylar width(LCW) and ML/LAP aspect ratio to compared the morphometric differences of distal femur between KBD and OA knees.Result: There were significant differences between KBD and OA knees in relation to ML, LAP, MAP, MCW and LCW dimensions(P <0.01). We also found that KBD have larger ML/LAP aspect ratio than that of OA knees under a given LAP dimension. This means that under a given LAP dimension component, the femoral ML dimension tended to undersized in KBD and overhang in OA knees.Conclusion: Distal femoral anatomy showed significant differences in the size and shape between KBD and OA knees, which provide vital theoretical basis for designing proper femoral prosthesis for KBD patients.
引文
[1]Ritter MA,Keating EM,Sueyoshi T,et al.Twenty-five-years and greater results after nonmodular cemented total knee arthroplasty[J].J Arthroplasty,2016,31(10):2199-2202.
[2]杨雷刚,高大龙,涂忠民,等.后稳定型全膝关节置换治疗成人膝大骨节病混合内翻畸形[J].实用骨科杂志,2012,18(8):700-703.
[3]Kim TK,Phillips M,Bhandari M,et al.What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races?A Systematic Review[J].Clin Orthop Relat Res,2017,475(1):170-182.
[4]Terrier A,Ston J,Farron A.Importance of a three-dimensional measure of humeral head subluxation in osteoarthritic shoulders[J].JShoulder Elbow Surg,2015,24(2):295-301.
[5]Gillespie RJ,Levine A,Fitzgerald SJ,et al.Gender differences in the anatomy of the distal femur[J].J Bone Joint Surg Br,2011,93(3):357-63.
[6]Loures FB,de Araújo Góes RF,da Palma IM,et al.Anthropometric study of the knee and its correlation with the size of three implants available for arthroplasty[J].Rev Bras Ortop,2016,51(3):282-289.
[7]Seil R,Pape D.Causes of failure and etiology of painful primary total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2011,19(9):1418-1432.
[8]Yang Bo,Yu Jiakuo,Zheng Zhuozhao,et al.Comparative Study of Sex Differences in Distal Femur Morphology in Osteoarthritic Knees in a Chinese Population[J].PLos One,2014,9(2):e89394.
[2]杨雷刚,高大龙,涂忠民,等.后稳定型全膝关节置换治疗成人膝大骨节病混合内翻畸形[J].实用骨科杂志,2012,18(8):700-703.
[3]Kim TK,Phillips M,Bhandari M,et al.What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races?A Systematic Review[J].Clin Orthop Relat Res,2017,475(1):170-182.
[4]Terrier A,Ston J,Farron A.Importance of a three-dimensional measure of humeral head subluxation in osteoarthritic shoulders[J].JShoulder Elbow Surg,2015,24(2):295-301.
[5]Gillespie RJ,Levine A,Fitzgerald SJ,et al.Gender differences in the anatomy of the distal femur[J].J Bone Joint Surg Br,2011,93(3):357-63.
[6]Loures FB,de Araújo Góes RF,da Palma IM,et al.Anthropometric study of the knee and its correlation with the size of three implants available for arthroplasty[J].Rev Bras Ortop,2016,51(3):282-289.
[7]Seil R,Pape D.Causes of failure and etiology of painful primary total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2011,19(9):1418-1432.
[8]Yang Bo,Yu Jiakuo,Zheng Zhuozhao,et al.Comparative Study of Sex Differences in Distal Femur Morphology in Osteoarthritic Knees in a Chinese Population[J].PLos One,2014,9(2):e89394.