保留前后交叉韧带的膝关节假体相关羊胫骨近端解剖研究

The anatomy of proximal tibia of goat to design the bi-cruciate ligament retaining knee prosthesis

目的验证在保留前后交叉韧带的人工膝关节假体的设计过程中应用羊膝关节作为动物模型的可行性。方法 40例正常志愿者及10只健康山羊进行膝关节的CT及MRI扫描,重建出完整羊及人的膝关节三维实体数字化模型并进行与假体相关的胫骨近端的解剖测量,并比较羊膝关节及人膝关节解剖参数的异同。结果羊膝关节前后交叉韧带宽度及胫骨棘的前后径约为人膝关节的2/5,截骨后胫骨平台前后径及内外径约为人膝关节1/2,两者具有较高的类似性。羊膝关节与人膝关节内侧截骨面具有相近的内外径与前后径比值(0.55 vs 0.54,t=1.47,P=0.13),但外侧截骨面内外径与前后径比值大于人膝关节(0.89 vs 0.74,t=8.24,P<0.05)。结论羊膝关节是进一步研究保留前后交叉韧带的人工膝关节假体较好的动物模型。

Objective To validated whether the goat stifle could be regarded as a useful model for the human knee to design bi-cru- ciate ligament retaining knee prosthesis. Methods Forty volunteer and ten stifles of goats were selected, then they were scanned with CT and MRI. These acquired image data were imported into computer and were carried through three-dimensional reconstruction by MIMICS soft- ware. By the models of the human knees and stifles of goats, the morphology indexes of the proximal tibial （ the dimension of anterior cruciate ligament and posterior eruciate ligament ,the dimension of tibial spine） were measured, and the dimension of the cut surface after simulation osteotomy [ anteroposterior（AP） and mediolateral（ML） dimension of resected surface, AP and ML dimension of medial and lateral reseeted surface] were also measured. Based on these, ML/AP ratio of reseeted surface was calculated ,and the ratio of human knees and goat stifles was compared. Results The width of anterior cruciate ligament, the width of posterior cruciate ligament and the dimension of tibial spine of the goat stifle were two-fifths of the human knee. The dimension of the cut surface of the goat stifle was one half of the human knee. The ML/ AP ratio of tibial medial reseeted surface of goat stifle was similar to the ratio of the human knee （0. 55 vs 0. 54, t = 1. 47, P = 0. 13 ） , howev- er, the ML/AP ratio of tibial lateral resected surface of goat stifle was greater than the ratio of the human knee（0. 89 vs 0. 74,t =8.24,P 〈 0. 05 ）. Conclusions The goat stifle represents an appropriate animal model of its human counterpart to design bi-cruciate ligament retaining knee prosthesis.