摘要
目的:探讨股骨远端及胫骨近端截骨后的各截骨面参数及髌骨参数对假体设计的指导意义。方法:选择2005-02/05在解放军总医院骨科住院治疗的77例患者,105个成人病态膝关节,其中男23例(32膝),女54例(73膝)。105个成人病态膝关节均为初次行人工全膝关节表面置换并在术中保留髌骨,术中测量股骨远端及胫骨近端截骨后的各个截骨面相关参数及髌骨参数。对所测得的全部数据均纳入统计学分析,采用stata8.0统计软件进行结果分析,对不同观察指标统计,求出均值及标准差。并给出股骨前髁宽、股骨前下髁宽、股骨髁宽及胫骨平台宽、胫骨平台内、外侧前后径之间的相关系数,给出回归方程。结果:纳入病态膝关节105例,均进入结果分析。确立了股骨髁及胫骨平台截骨后的各个参数之间的比例关系:①股骨前髁宽A与股骨髁宽C存在线性关系(P<0.05),相关系数:0.7583,回归方程A=-1.523+0.754C。②股骨前下髁宽B与股骨髁宽C存在线性关系(P<0.05),相关系数:0.8555,回归方程B=5.7746+0.8197C。③胫骨平台宽M与股骨髁宽C存在线性关系(P<0.05),相关系数:0.8596,回归方程:M=24.6349+0.7021C。④胫骨平台内侧前后径L与胫骨平台宽M存在线性关系(P<0.05),相关系数:0.8306,回归方程L=-7.8010+0.7729M。⑤胫骨平台外侧前后径N与胫骨平台宽M存在线性关系(P<0.05),相关系数:0.7288,回归方程:N=-1.7405+0.6129M。⑥胫骨外侧平台前后径比内侧平台前后径小5.76mm。结论:精确测量并统计了国人膝关节的形态学尺寸,提供了成人病态膝关节股骨远端及胫骨近端截骨后各个截骨面的参数及髌骨参数指标参考值,为人工膝关节假体的设计、制作提供了更加符合国人解剖结构的科学依据,可以提高假体的适配度,进而提高人工全膝关节置换术的整体临床性能。
AIM： To analyze the guiding significance to the designing of prosthesis by measuring of the morphologic dimensions data of the distal part of the femur and the proximal part of the tibia of the osteotomied face and the patella.
METHODS： This clinical trial was carried out in Department of Orthopedic Surgery, General Hospital of Chinese PLA from February to May 2005 in 77 patients （105 knees） included 23 men （32 knees） and 54 women （73 knees）. They were measured during total knee arthroplasty （TKA） and the patella was kept in the operation. The morphologic dimensions data of the distal part of the femur and the proximal part of the tibia of the osteotomied face and the patella were measured. All the measured data were involved in the statstical analysis. The different observational index was calculated; mean value and standard deviation of the above were summed up by stata 8.0 software, Coefficient correlation and regression equation among the width of femoral condyle, width of lower femoral codyle, width of femoral condyle （A, B, C） and the width of tibial platform, sagittal length of medial ＆ lateral tibial platform were got at the same time.
RESULTS： A total of 105 injured knee joints were involved in the result analysis. The proportion of each parameter of femoral condyle and tibial platform was defined. ①There was linear correlation between the width of femoral condyle A and C （P 〈 0.05）coefficient correlation：0.758 3, regression equation：A=-1.523＋0.754 C. ②There was linear correlation between the width of femoral condyle B and C （P 〈 0.05） coefficient correlation：0,855 5, regression equation：B=5,774 6＋0,819 7 C, ③There was linear correlation between the width of tibial platform and the femoral condyle C （P 〈 0,05）coefficient correlation：0,859 6, regression equation： M= 24.634 9＋0,702 1 C. ④The width of tibial platform and the sagittal length of medial tibial platform correlated to each other （P 〈 0,05） coefficient correlation： 0.830 6, regression equation：L=-7,801 0＋0,772 9 M, ⑤. The width of tibial platform and sagittal length of lateral tibial platform correlated to each other （P 〈 0.05） coefficient correlation： 0.728 8, regression equation：N=-1.740 5＋0.612 9 M. ⑥Sagittal length of lateral tibial platform was shorter than sagittal length of medial tibial platform by 5,76 mm. CONCLUSION： The study measures and adds up exactly geometrical morphological dimensions of Chinese＇s knee joint, and provides reference data of distal part of the femur and the proximal part of the tibia of the osteotomied face and the patella of the adult＇s abnormal knees. The resultsare close to the Chinese anatomical structure so it can provide more scientific evidence to the designing and manufacturing of knee joint prosthesis. The application of these data will improve the fitness degree of the prosthesis in order to elevate the clinical effect of the TKA.
出处
《中国临床康复》
CSCD
北大核心
2006年第8期28-31,i0001,共5页
Chinese Journal of Clinical Rehabilitation
基金
首都医学发展科研基金(2002-1009)~~
