国人正常胫骨近端面积参数测量及特性分析

Measurement and characteristic analysis of proximal tibia area parameters in normal Chinese populations

背景：人工全膝关节置换所选假体的形状、尺寸是否与膝关节相匹配,将明显影响手术及术后长期效果。由于缺少对中国人群体质参数的研究,中国关节外科领域缺少膝关节特性数据和国产化膝关节假体。目的：获取中国人群正常胫骨近端不同截面面积参数正常参考值。方法：纳入82例中国成人正常膝关节135膝,男85膝,女50膝,年龄47.2（19~82）岁;按照性别、年龄和侧别进行分组,利用原始CT扫描图像资料重建膝关节,并在工作平台上对胫骨进行旋转、切割,测量计算不同截面的总面积。结果与结论：测得各膝关节胫骨近端截面的总面积为（3232.33±405.19）mm2,并分析得出男性截面面积平均值明显大于女性（P〈0.01）;而不同侧别、不同年龄段、不同截骨高度及不同的截骨后倾角之间截面面积差异无显著性意义（P〉0.05）。结果说明进行全膝关节置换及设计中国人膝关节假体时应该注意到性别差异。实验初步获得了胫骨近端不同截面各面积参数正常参考值,从而为国产人工膝关节假体设计以及全膝关节置换临床操作提供了一定参考依据。

BACKGROUND：Whether the shape and dimension of the total knee arthroplasty prosthesis are matched to the knee joint significantly affect the operation and postoperative effect.There are few researches of the Chinese proximal tibia parameters,so it is necessary to explore the characteristic data and domestic prosthesis.OBJECTIVE：To obtain the normal area parameters on the different resection levels of normal proximal tibia in Chinese.METHODS：A total of 82 normal Chinese（135 knees）,including 85 knees in males and 50 knees in females,with an average age of 47.2 years（range from 19 to 82 years）,were divided into groups according to the age,side of the knee and gender.Original CT image data were utilized to set up the three-dimensional model of Chinese normal knees and measure the related area parameters of proximal tibia section on the work station.RESULTS AND CONCLUSION：The average area of the proximal tibia section was（3 232.33±405.19） mm2.Statistics analysis showed that the area parameters of males were significantly greater than the females（P 0.01）,while there was no significant differences in area among different side,age,resection bone height and inclination angel（P 0.05）.The sex differences should be considered when designing the domestic tibial plateau prosthesis and total knee arthroplasty.The study obtained primary normal reference values of geometry of proximal tibia in Chinese,which provides evidence for clinical operation of tibial plateau prosthesis design and total knee arthroplasty.