股骨远端及后髁曲率半径的性别差异及其意义

Gender differences in curvature radius of distal femur and hypocondyle and their significances

目的:利用影像学方法研究股骨远端和股骨后髁的曲率半径,比较内外侧髁之间和男女性别间的形态学差异,为膝关节假体设计提供形态学依据。方法:选取69个正常膝关节行伸膝关节180°核磁成像,在矢状位图像测量股骨内外侧髁的前后径(AP)、股骨远端曲率半径(rd)及股骨后髁曲率半径(rh),取内侧髁曲率半径指数(MCI)、外侧髁曲率半径指数(LCI)、股骨远端曲率半径指数(DCI)、股骨后髁曲率半径指数(HCI)作为衡量股骨远端和股骨后髁曲度的标准。结果:男性股骨内侧髁rd为(32.58±4.84)mm,rh为(19.04±3.33)mm;外侧髁rd为(32.82±3.95)mm,rh为(19.38±2.80)。女性股骨内侧髁rd为(29.40±4.15)mm,rh为(15.99±2.38)mm;外侧髁rd为(29.30±3.16)mm,rh为(16.41±2.01)mm。男性MCI和LCI均大于女性(P<0.05),女性DCI大于HCI(P<0.05)。男女性内外侧髁AP、rd和rh存在显著的双变量线性回归关系(P<0.001)。结论:男女性股骨内外侧髁曲度有较大差异,女性股骨曲度大,尤其是股骨内后髁。膝关节假体股骨部件的内外侧后髁应采用不对称曲度设计,加大内侧髁远端曲度,使之与曲度较大的内后髁形成连续半径设计。

Objective To investigate the curvature radius of distal femur and hypocondyle by imageological methods and compare the differences between them and gender differences between male and female, and provide morphological basis for design of knee joint prosthesis. Methods 69 cases of normal knee undergoing magnetic resonance imaging in knee extensor 180 ° position were selected in sagittal images, the anterioposterior dimension （AP）, rd and rh were measured and the medial curvature index （MCI）, lateral curvature index （LCI）, distal condyle curvature index （DCI） and hypocondyle curvature index （HCI） were used as the curvature standards of distal femur and the femoral posterior condylar. Results The rh of male medial condyle was （32. 58±4. 84） mm, r, was （19.04±3.33） ram; rh of male lateral condyle was （32.82±3.95） mm, rh was （19. 38±2.80） . The r, of female medial condyle was （29.40 ±4.15） mm, rh was （15. 99 ± 2. 38） mm; the ra of female lateral condyle was （29.30±3.16） mm, rh was （16. 41±2. 01） mm. The data showed statistical difference in MCI and LCI between male and female （P〈0.05）. There was statistical difference between female DCI and HCI （P〈0.05）. The result of two-variable linear regression analysis showed the linear regression between AP, rh and ra （P 〈0. 001）. Conclusion There are statistical differences in distal femur and hypocondyle curvature between male and female. The curvature of female is larger, especially the medial hypocondyle. It is suggested that the asymmetry curvature design should be taken for the prosthesis＇ s hypocondyle part, that is, the curvature of medial distal condyle should be increased to form a continuous radius design with the medial hypocondyle which has larger curvature.