CAJ | 학술논문

目的利用数字化技术获取健康成人正常胫骨近端截而及假体的参数参考值,探讨适合不同人种且具有性别差异的胫骨假体设计.方法对55名志愿者中的92侧正常膝关节(男42侧,女50侧)进行螺旋CT扫描,将断层扣描数据导入Mimics10.1软件建立膝关节三维数字模型,然后将模型导入Geomagic Studio 8软件系统对胫骨近端模型进行模拟截骨、形态学测量,分析不同性别胫骨近端截面的形态学差异.再将获得的模型与通过激光扫描获得的假体(PFC和Nexgen)三维模型进行模拟装配、参数测量.结果胫骨近端截骨面的前后径(AP)为(49.87 ±3.90)mm、内外侧横径(ML)为(73.50±5.60)mm,AP与ML呈正相关.男性胫骨平台AP为(53.24±4.10)mm、ML为(75.85±3.50)mm,均比女性[AP为(47.61±3,70)mm,ML为(67.68±2.60)mm]大.内侧前后径(MAP)比外侧前后径(LAP)大,男性平均大(3.90±2.90)mm,女性平均大(3.70±2.70)mm.PFC假体(0.75±0.05)和Nexgen假体(0.69±0.03)的AP/MP比值与本研究正常成人(0.68±0.03)相比,差异均有统计学意义(P<0.05).结论不同性别及人种的胫骨截面形态存在显著差异,为提高人工膝关节胫骨假体的覆盖率,胫骨假体设计及临床操作均要考虑不同人种和性别的形态学特点.
목적 이용수자화기술획취건강성인정상경골근단절이급가체적삼수삼고치,탐토괄합불동인충차구유성별차이적경골가체설계.방법 대55명지원자중적92측정상슬관절(남42측,녀50측)진행라선CT소묘,장단층구묘수거도입Mimics10.1연건건립슬관절삼유수자모형,연후장모형도입Geomagic Studio 8연건계통대경골근단모형진행모의절골、형태학측량,분석불동성별경골근단절면적형태학차이.재장획득적모형여통과격광소묘획득적가체(PFC화Nexgen)삼유모형진행모의장배、삼수측량.결과 경골근단절골면적전후경(AP)위(49.87 ±3.90)mm、내외측횡경(ML)위(73.50±5.60)mm,AP여ML정정상관.남성경골평태AP위(53.24±4.10)mm、ML위(75.85±3.50)mm,균비녀성[AP위(47.61±3,70)mm,ML위(67.68±2.60)mm]대.내측전후경(MAP)비외측전후경(LAP)대,남성평균대(3.90±2.90)mm,녀성평균대(3.70±2.70)mm.PFC가체(0.75±0.05)화Nexgen가체(0.69±0.03)적AP/MP비치여본연구정상성인(0.68±0.03)상비,차이균유통계학의의(P<0.05).결론 불동성별급인충적경골절면형태존재현저차이,위제고인공슬관절경골가체적복개솔,경골가체설계급림상조작균요고필불동인충화성별적형태학특점.
Objective To determine the anthropometric data of the resected proximal tibia in a Chinese population for the design of Chinese tibial prostheses.Methods We carried out anthropometric measurements,using three dimensional computer tomography,of the proximal tibial sections of 92 knees that bad been harvested from 42 male and 50 female Chinese cadavers.We measured the mediolateral(ML),middle anteroposterior(AP),medial and lateral anteroposterior dimensions and the ML/AP ratio of the resected proximal tibial surface.We then compared the data with the parameters of the 2 conventionally used symmetric total knee components(DePuy and Zimmer).Furthermore,the ML/AP ratio of the study population was also compared with that of the currently available prostheses.Results We found that the average ML[(73.50 ±5.60)mm]and AP[(49.87 ± 3.90)mini dimensions of the study population were smaller than those of the commercially available TKA implants.We found the ML/AP ratio decreased with the increase in the AP dimension of the proximal tibia,as compared to the constant ML/AP ratio shown in the conventional tibial prostheses.Both the small and large-sized prostheses were found to be mediolaterally unfitting.Conclusion We suggest redesigning the ML/AP ratio of the tibial component to match the shape of the proximal tibia in the Chinese population.