髌股关节形态测量及其在膝关节假体设计中的应用

Geometrimorph of patello-femoral joint and its application in design of total knee prosthesis

目的:利用影像学方法研究髌股关节各部件的形态及相互关系,为膝关节假体设计提供理论依据。方法:对48例志愿者膝关节进行不同位置MRI成像,在水平位、冠状位和矢状位的膝关节MRI图像上观察测量髌股关节各部件的形态及相互关系,并对关节接触面宽度和角度的比值进行直线相关分析。结果:男性髌骨高(41.87±4.67)mm,宽(41.08±4.30)mm;女性髌骨高(35.34±5.15)mm,宽(36.71±3.07)mm。48例研究对象中髌骨属不稳定型的比例高达37.50%(18/48)。男性股骨远端宽(80.70±6.40)mm,女性股骨远端宽(70.64±8.70)mm;女性髌骨的髁间窝和股骨沟均比男性髌骨小。高度屈曲时髌骨和股骨接触区域的宽度比、角度比大于1这一接触形式占优势。结论:髌骨关节面与股骨远端形态复杂,硬组织对合较差。全膝关节置换假体设计应注重髌股关节的良好吻合,降低接触面应力,并充分考虑到男女性关节形态的差异。

Objective To research the geometrimorph of patello-femoral joint and the geometric correlation between its components by imageological methods and provide theoretical basis for total knee prosthesis design. Methods The geometrimorph of patello-femoral joint of 48 volunters was observed and measured on MRI images. Results The height of male patella was （41.87±4. 67） mm; the width was （41.08±4.30） mm, while the height of female patella was （35.34±5.15） mm, the width was （36.71±3.07） mm. The proportion of unstable Chinese patella was 37.50%. The width of male distal femur was （80.70±6.40） mm, while it was （70.64±8. 70） mm in female. Moreover, the female femur ditch and intercondylar fossa were far smaller than male. When the ratios of width and angle for the contact area were both larger than 1, knee joints bent highly and freely. Conclusion The fine fitness of patello-femoral joint, the difference of knee joint morphorlogy between men and women, and arthroscopy for knee are very important in design of total knee prosthesis.