国人膝关节数字化骨形态学研究

Digital Morphological Research on the Joint of the Knee in Chinese People

目的利用数字化技术获得膝关节股骨和胫骨形态学数据,分析国人膝关节的解剖形态,为制作适合国人的膝关节假体提供依据。方法对正常膝关节进行CT扫描,应用Mimics10.01进行膝关节三维重建,定位、模拟截骨,测量股骨远端、胫骨近端各参数,结果用统计软件IBM SPSS Statistics 19.0统计学软件分析处理,得出各参数的均值、标准差及相关系数,分析截骨深度对胫骨平台尺寸以及性别、侧别对股骨髁、胫骨平台参数的影响。建立了膝关节数字模型数据库,股骨髁内外径为(77.93±5.99)mm,股骨髁内外侧前后径与内外径比值分别为(0.73±0.04)和(0.78±0.03),胫骨横径为(71.99±5.96)mm,胫骨前后径与横径比值为(0.66±0.03);股骨髁、胫骨平台各参数有很好的相关性,男女膝大部分参数差异均具有统计学意义,左右侧别差异无统计学意义。结论基于CT影像的膝关节数字化三维重建,可精确截骨、测量,探索了国人膝关节相关参数的相互关系,为膝关节假体设计提供了形态学数据。

Objective To obtain the femoral and tihial morphological data of the knee joint by digital technology and analyze the anatomical features of the knee joint of Chinese people in order to provide data for the preparation of the optimal prosthesis of the knee joint for Chinese population. Methods The three dimensional digital model of the knee joint was reconstructed by using software Mimics 10.01 after input of the data of CT images of the normal knee joint. The proximal tibia was positioned,osteotomy was simulated, and the parameters of distal femur and proximal tibia were measured. The mean and standard deviation of each variable and the coefficient of correlation were obtained by using IBM SPSS Statistics 19.0. The effect of the depth of osteotomy on tibia platform was analyzed as well as the effect of gender,laterality on the parameters of femoral condyle and tibia platform. Results The database of digital knee models was established. The transverse diameter of the femoral condyle was （77.93±5.99） mm;the inside/outside anteroposterior to medial lateral ratio of the femur was about （0.73±0.04）and （0.78±0.03） ;the transverse diameter of the tibia was （71.99±5.96） mm;the anteroposterior to transverse ratio of the tibia was about （0.66±0.03）. Most parameters of femur and tibial platform had great correlation. There was a significant difference in most parameters of the knee between females and males. But no significant difference in the laterality was found. Conclusion The digital reconstruction of the knee joint based on CT images contributes to precise osteotomy, measurement, examination of the correlation of each variable of the knee joint,which provides morphological data for the design of knee prosthesis.