国人全膝置换术股骨远端截骨面解剖参数测量△

Anatomic measurement of the distal femur in Chinese for total knee replacement

摘要:

[目的]应用三维 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]2022 年 3 月—2022 年 10 月对 187 例（男 94 例，女 93 例）汉族正常膝关节进行 CT 三维重建，测量股骨内外径（medial-lateral, ML）、股骨前后径（anterior-posterior, AP）、股骨内侧髁宽度（medial condyle width, MCW）、股骨外侧髁宽度 （lateral condyle width, LCW）、股骨髁间窝宽度 （width of intercondylar fossa, WICF）、股骨髁间窝高度 （height of intercon- dylar fossa, HICF），并计算 ML/AP 比值，比较各参数性别差异及相关性。[结果] 股骨远端各解剖数据测量值男性均显著大于女性 （P＜0.05）。股骨远端截骨面测量值中除 MCW 与 WICF （r=0.087, P=0.236）、LCW 与 WICF （r=0.052, P=0.478）、HICF 与 ML/AP （r=0.023, P=0.757） 之间无显著的相关关系，其余各测量值均存在显著正相关 （P＜0.05）。股骨远端 ML/AP 与 AP 成显著负相关 （P＜0.05），随着 AP 的增大 ML/AP 减小。在相同 AP 值下，男性股骨 ML/AP 显著大于女性 （P＜0.05）。[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] To provide reference for the design of domestic knee femoral prosthesis by CT measurement of the anatomical and morphological parameters of the distal femoral osteotomy surface of the knee in normal Chinese people. [Methods] From March 2022 to October 2022, 187 normal ethnic Han Chinese, including 94 males and 93 females, underwent CT three-dimensional reconstruction of the knee. The mediolateral diameter (ML), anteroposterior diameter (AP), medial condyle width (MCW), lateral condyle width (LCW), width of intercondylar fossa (WICF), and height of intercondylar fossa (HICF) were measured, in addition, the ML/AP ratio were calculated. The gender differences and correlations of each parameter were searched. [Results] The males were measured significantly greater anatomical data of the distal femur than females (P＜0.05). Although there was no significant correlation between MCW and WICF (r=0.087, P=0.236), LCW and WICF (r=0.052, P=0.478), HICF and ML/AP (r=0.023, P=0.757), significantly positive correlations among other measurements were noted (P＜0.05). The ML/AP of distal femur was negatively correlated with AP (P＜0.05), in other word, the ML/AP decreased with the increase of AP. At the same AP value, the male had significantly greater ML/AP than the female (P＜0.05). [Conclusion] Chinese men and women have considerable differences in size and shape of distal femoral osteotomy. ML/AP should be considered as a reference in designing femur prostheses with gender differences.