CAJ | 학술논문

目的测量中国北方汉族人胫骨平台截骨面与进口胫骨假体解剖学参数的偏差.方法中国北方汉族健康志愿者82名(135膝),男52名(85膝),女30名(50膝);年龄19～ 82岁,平均47.2岁.行膝关节横断面CT扫描,获得“.dicom”格式图像.将图像存储至与CT机联网的计算机三维重建工作站(Adw 4.3),利用三维容积重建软件建立膝关节三维图像.对三维图像的胫骨进行旋转、切割,测量不同截骨高度及后倾角度各截骨面的胫骨近端横径、前后径及纵横比;采用5 mm容差范围法对三种西方进口假体(A、B、C)与国人胫骨平台截骨面的匹配程度进行初步评估.结果男性胫骨近端截骨面横径平均值为(78.03±2.92) mm,女性为(69.85±2.70)mm;男性胫骨近端截骨面前后径平均值为(50.62±2.46)mm,女性为(46.14±2.61)mm;男性胫骨近端截骨面纵横比平均值为0.649±0.032,女性为0.661±0.031.不同性别胫骨近端截骨面横径与前后径的差异均有统计学意义,男性大于女性;纵横比平均值女性大于男性,差异有统计学意义.假体A对所有受试者各截骨面的平均涵盖率为42.55％,假体B平均为44.61％,假体C平均为27.41％.A与B两种假体涵盖率的差异无统计学意义,而两者与假体C涵盖率的差异均有统计学意义.结论国人正常胫骨平台截骨面的几何形态与西方进口假体的匹配度普遍较低.
목적 측량중국북방한족인경골평태절골면여진구경골가체해부학삼수적편차.방법 중국북방한족건강지원자82명(135슬),남52명(85슬),녀30명(50슬);년령19～ 82세,평균47.2세.행슬관절횡단면CT소묘,획득“.dicom”격식도상.장도상존저지여CT궤련망적계산궤삼유중건공작참(Adw 4.3),이용삼유용적중건연건건립슬관절삼유도상.대삼유도상적경골진행선전、절할,측량불동절골고도급후경각도각절골면적경골근단횡경、전후경급종횡비;채용5 mm용차범위법대삼충서방진구가체(A、B、C)여국인경골평태절골면적필배정도진행초보평고.결과 남성경골근단절골면횡경평균치위(78.03±2.92) mm,녀성위(69.85±2.70)mm;남성경골근단절골면전후경평균치위(50.62±2.46)mm,녀성위(46.14±2.61)mm;남성경골근단절골면종횡비평균치위0.649±0.032,녀성위0.661±0.031.불동성별경골근단절골면횡경여전후경적차이균유통계학의의,남성대우녀성;종횡비평균치녀성대우남성,차이유통계학의의.가체A대소유수시자각절골면적평균함개솔위42.55％,가체B평균위44.61％,가체C평균위27.41％.A여B량충가체함개솔적차이무통계학의의,이량자여가체C함개솔적차이균유통계학의의.결론 국인정상경골평태절골면적궤하형태여서방진구가체적필배도보편교저.
Objective To obtain the linear parameters of proximal tibia in normal Chinese,and study the anatomical differences between the resected tibial surfaces and tibial baseplates of total knee prostheses.Methods A total of 82 normal Chinese / 135 knees (include 85 male and 50 female knees) was included,with an average age of 47.2 (range,19-82) years.All of the volunteers were scanned by Spiral CT,and the original CT images were stored in the work station (Adw 4.3).Then 3-D models of Chinese normal knees were reconstructed and two parameters were measured through volume reconstruction software,including mediolateral (ML) width and anterioposterior (AP) length.A coordinate system was formed with the mediolateral width as the X-axis and anterioposterior length as the Y-axis.A circle,5 mm in diameter,was used as the maximum coverage criterion.Three contemporary products (A,B,C) were used to analyze the data.From the results,we calculated the coverage percentage of the patients.Results The average ML width and AP length of the proximal tibia section were 78.03±2.92 mm and 50.62±2.46 mm in male,and 69.85±2.70 mm and 46.14±2.61 mm in female,respectively.The average ratio of AP length and ML width (RAP/ML) was 0.649 ±0.032 in male and 0.661± 0.031 in female,respectively.AP length and ML width showed statistical significance between different genders.The RAP/ML was larger in female,and the difference was statistically significant.The average coverage rate of prosthesis A,B and C was 42.55％,44.61％ and 27.41％,respectively.There was no statistically significant difference between prosthesis A and B.However,all of them showed statistical significance with prosthesis C.Conclusion The geometry and anatomy of proximal tibia in Chinese showed significant differences with that in Western.Those characteristic differences should be considered when we use the tibial plateau prosthesis designed by the Westerners.