国人全膝置换术股骨远端截骨面解剖参数测量

Resected distal femoral anatomy measurement for total knee replacement

摘要:

[目的] 三维CT重建测量正常国人膝关节股骨远端截骨面解剖形态学参数，为国产人工膝关节股骨假体的设计提供参考依据。[方法] 187例(男94膝，女93膝)汉族正常国人膝关节CT进行三维重建和截骨，测量股骨内外径（ML）、股骨前后径（AP）、股骨内侧髁宽（MCW）、股骨外侧髁宽（LCW）、股骨髁间窝宽度(WICF)、股骨髁间窝高度(HICF)，并计算ML/AP比值，比较股骨远端各解剖形态参数性别差异。[结果] 男性股骨远端各解剖数据测量值均大于女性，差异有统计学差异（P<0.01）。股骨远端ML/AP与AP成负相关，随着AP的增大ML/AP减小。在相同AP值下，男性股骨ML/AP大于女性，显示一个给定AP尺寸假体,男性股骨ML有可能会覆盖不全,女性悬空。[结论] 国人股骨远端截骨面男性和女性存在尺寸和形态的差异，在设计股骨假体时，ML/AP应该考虑作为参考设计性别差异性股骨假体。

Abstract:

[Objective] The purpose of this study was to measure and analyze morphologic feature of resected distal femoral surface in normal knees between the males and females. [Methods] 187 normal knees (94 males, 93 females) were measured by computed tomography for the distal femoral mediolateral (ML), anteroposterior (AP), width of medial condyle (MCW), width of lateral condyle(LCW), Width of intercondylar fossa(WICF), Height of intercondylar fossa(HICF) and ML/AP aspect ratio to compared the differences of resected distal femoral surface between males and females. [Results] There were signi?cant morphologic differences in resected distal femoral surface between males and females (P<0.01). We found a progressively decreased in the ML/AP aspect ratio with an increasing AP dimension, and distal femoral showed same AP dimensions resulting in a higher ML/AP aspect ratio in males and a lower ML/AP aspect ratio in females. This means that under a given AP dimension prosthesis, the femoral ML dimension have the potential to be undersized in males and to overhang in females. [Conclusion] Distal femoral showed significant differences in the size and shape between males and females. The results can provide important reference in designing proper gender-specific femoral prosthesis with different ML/AP aspect ratio in future.