基于CT的中国正常成人踝关节三维形态学分析及应用研究

Three-dimensional morphological analysis and application research of ankle joint in Chinese normal adults based on CT

目的通过对中国人群踝关节形态学参数进行测量和统计分析,为踝关节置换术假体的设计提供理论基础和形态学数据支撑。方法模拟人工踝关节置换手术,对191例(男性106例、女性85例)踝关节CT影像数据行三维重建,重建图像测踝穴前后倾斜角(APA)、胫骨下端最大前后径(MTiTh)等32个形态学参数,并计算胫骨平均纵横比(MTiTh/TiW)和距骨平均纵横比(TaAL/TaW)等3项参数比。结果(1)所检验32个参数中有23个存在性别间差异(P<0.05),其中除踝穴前后倾斜角(APA)和踝穴前后距(APG)等3个参数外,其余20个参数为男大于女;(2)测量数据与之前本课题基于X线片结果比较,除踝穴前后距(APG)、踝穴前后倾斜角(APA)、胫骨远端滑车切迹长(TiAL)等3个参数外,其余8个参数均有显著性差异(P<0.05),且X线片大于CT;(3)由于种族与地域等的差异,中国正常成人踝关节三维形态学参数与法国、意大利、韩国、中国台湾人群等既往研究数据相比,数据之间存在差异;距骨体形态与埃及、希腊和华北地区人群存在差异。结论中国成人人群踝关节形态学参数与西方人群间存在差异。

Objective To provide a fundamental basis and morphological database for the design of total ankle arthroplasty(TAA)prosthesis by measuring the ankle joint morphology and analyzing the results in the Chinese population.Methods The computer tomography(CT)images of 191 ankle points(106 in males and 85 in females)were three-dimensional(3D)reconstructed and 32 morphologic parameters were measured such as anterior-posterior inclination angle(APA)and maximal tibial thickness(MTiTh)on the 3D reconstruction model,and the ratios of 3 parameters such as the ratios of the arc length and width of the tibial mortise(MTiTh/TiW)and the trochlea tali(TaAL/TaW)were calculated.Results(1)In terms of gender,there were significant differences in 23 parameters among the 32 parameters tested(P<0.05).The other 20 parameters in males were found larger than that in females except for following 2 parameters:APA and anterior-posterior gap(APG).(2)Compared with the results of our previous study based on X-ray,there were 8 parameter different between X-rays and CT reconstruction images except for the following 3 parameters:APG,APA and tibial arc length(TiAL).The results based on X-ray were larger than that in CT reconstruction images.(3)Due to the differences of race and region,the 3D morphological parameters of the ankle joint in normal Chinese adults were different from those of French,Italian,Korean,and Taiwan population.The morphology of the talus differed from that of Egyptian,Greek and north China.Conclusions There was significant differences in the morphological parameters of ankle joints between Chinese adults and Western adults.