中国汉族与维吾尔族胫骨平台几何特点的对比及临床意义研究

Geometrical characteristics of tibial plateau:a comparative study between Han people and Uygur people

[目的]通过对新疆维吾尔族胫骨平台几何参数的测定为提高少数民族全膝关节置换术的成功率及假体匹配性提供数据支持;同时对中国汉族与新疆维吾尔族胫骨平台几何特征的对比,掌握我国民族间的差异和共性,为假体多样性设计及选择提供理论依据。[方法]选取50例/100膝（男50膝,女50膝）汉族人正常膝关节,年龄18~74岁,平均43.2岁。选取100例/200膝（男100膝,女100膝）维吾尔族人正常膝关节,年龄18~65岁,平均31.4岁。按照性别进行分组,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,测量胫骨平台相关线性参数。[结果]同一民族组内比较,男性胫骨平台各项线性指标均明显大于女性（P〈0.01）;外侧平台比内侧平台宽,但前后径小于内侧平台（P〈0.05）;维吾尔族受试组胫骨平台的内外侧宽及内外侧前后径分别要比同性别的汉族受试组更接近（P〈0.05）;在汉族和维吾尔族受试组中,胫骨平台宽与内外侧胫骨平台前后径存在着正相关关系（P〈0.05）;维吾尔族受试组男性、女性胫骨平台线性参数分别大于同性别的汉族受试组（P〈0.05）,但小于西方人群。[结论]维吾尔族人正常胫骨平台形态同汉族国人存在一定的区别;应用西方人设计的胫骨平台假体要考虑到维吾尔族人的特点和性别差异;设计国人膝关节假体以及进行全膝关节置换手术时应该注意到民族及性别的差异。

[Objective]To improve the success rate of total knee arthroplasty in minority nationalities in northwest area of China by means of measurement of geometrical characteristics of tibial plateau in Uygur people in Xinjiang municipality.And to provide theoretical basis of diversity designing of prosthesis by comparative study between Han nationality and Uygur nationality. [Method]Fifty normal Han people（100 knees,50 male and 50 female） were selected for this study,with average age of 43.2 years（ranged,18-74 years）.Another 100 normal Uygur people（200 knees,100 male and 100 female） were selected,with average age of 31.4 years（ranged,18-65 years）.They were divided into groups according to gender.Three-dimensional model of normal knee were set up from original CT image data,and related linear parameters of tibial plateau were gained on the work station.[Result]In a same nationality,linear parameter in male was higher than in female,with significant difference（P0.01）.Width of lateral tibial plateau（WLTP） was wider than width of medial tibial plateau（WMTP）,sagital length of medial tibial plateau（SLMTP） was longer than sagital length of lateral tibial plateau（SLLTP）（P0.05）.Gaps between WMTP and WLTP,SLMTP and SLLTP in the Uygur people were more approximate than in Han people,respectively（P0.05）.Positive correlation was found between width of tibial plateau and SLLTP,or SLMTP both in Han people and Uygur people.The linear geometric parameters of tibial plateau in Uygur people was higher than in Han people in the same sex,but lower than in western people.[Conclusion]The geometry of tibia plateau in Uygur showed significant difference comparing with Han people.The characteristics and the gender difference in Uygur people should be considered when applying tibia plateau prosthesis designed by western people.Discrepancy among different nationalities should be taken into account in total knee arthroplasty.