Abstract:Objective To find the relationship among femoral condyle sagittal transverse diameter ratio,height of patella and posterior tibial slope angle and provide guidance for the selection in size of the femoral prosthesis and posterior condylar osteotomy line arrangements in Total knee arthroplasty.Methods CT images were scanned,three-dimensional reconstruction was rebuilt and measuredusing HiNet PACS 5 software.According to the different gender and side group,received the measurement data using linear regression,t test and other statistical methods.P value less than 0.05 was defined as statistically significant.Results The ratio of femoral condyle and sagittal transverse diameter was in the range of 0.80~0.97 obtained from 160 normal knees;The heightof patellarand posterior tibial slope angle:Female group was significantly greater than the male group (P<0.001 and P<0.001,respectively)and no significant difference between left and right side (P>0.05 and P>0.05,respectively).To obtain the normal linear parameters,the ratio of femoral condyle and sagittal transverse diameter was positively correlated with the height of patella(male,r2=0.358;female,r2=0.689,respectively),while the ratio of femoral condyle and sagittal transverse diameter was not positively correlated to patellar height orposterior tibial slope angle.Conclusion Chinese knee joint femoral condyle sagittal transverse diameter ratio is relatively larger than the current mainstream foreign femoral condyle prosthesis,and it is positively correlated with the height of patella.However,in TKA increase or decrease the posterior tibial osteotomy angle,cannot change the posterior condylar osteotomy line position and the relative height of patella.
郝岩,张树明,周密,王晓宇,张巍,傅捷 *. 北京地区健康成人膝关节测量及其临床意义[J]. 实用骨科杂志, 2017, 23(4): 323-327.
HaoYan,Zhang Shuming,Zhou Mi,et al. Measurement and Clinical Value of the Knee Joint in Normal People in Beijing. sygkzz, 2017, 23(4): 323-327.
[1]吕厚山.人工膝关节置换术的进展和现状[J].中华外科杂志,2004,42(1):30-33.
[2]Mason JB.The new demands by patients in the modern era of total joint arthroplasty[J].Clin Orthop Relat Res,2008,466(1):146-152.
[3]Akasaki Matsuda S,Shimpto T.Contact stress analysis of the conforming post-cam mechanism in posterior-stabilized total knee arthroplasty[J].J Arthroplasty,2008,23(5):736-743.
[4]Sadoghi P,Kr-pfl A,Jansson V,et al.Impact of tibial and femoral tunnel position on clinical results after anterior cruciate ligament reconstruction[J].Arthroscopy:J Arthroscopic Relat Surg,2011,27(3):355-364.
[5]孙明举,王岩,陈继营,等.国人正常膝关节几何学及其参数的测量[J].解放军医学杂志,2002,27(12):1050-1052.
[6]Marmor L.Technique for patellar resurfacing in total knee anthrophlasty[J].Clin Orthop,1998(230):166.
[7]张树栋,曲文运.胫骨后倾角解剖与放射学测量评价[J].中华骨科杂志,2000,20(4):210-211.
[8]Miyake T.Studies on the sizes and shape of Japanese knee and their applications to the design of the knee prosthesis[J].J Jap Orthop Asso,1978,52(1):865.
[9]Figgie H,Goldberg V,Heiple K,et al.The influence of tibial-patellofemoral location on function of the knee in patients with a posterior stabilised condylar knee prosthesis[J].J Bone Joint Surg(Am),1986,68(7):1035-1040.
[10]Erknan MJ,Walker PS.A study of knee geometry applied to the design of condylar prostheses[J].Biomed Eng,1974,9(1):14-17.
[11]周飞虎,王岩,周勇刚.国人正常股骨远端三维模型及骨形态测量研究[J].中国临床康复,2005,9(6):62-63.
[12]周程沛,何军慧,周宗科,等.中国南方人正常膝关节CT测量与假体设计[C].广州:第20届中国康协肢残康复学术年会,2011.
[13]胡猛,李彦林,仝路.股骨远端旋转力线定位标志研究进展[J].中国修复重建外科杂志,2013,27(1):54-57.
[14]吴蔚,许建中,郭漳生.成人正常股骨解剖测量及其在膝关节置换的临床意义[J].中国矫形外科杂志,2006,14(3):200-202.
[15]胡彬,谢兴文,黄晋,等.髌骨形态异常与膝关节骨关节炎之间相关性[J].实用骨科杂志,2014,20(10):905-909.
[16]周欣,韦民,王伟.高屈曲度固定平台和高屈曲度旋转平台膝关节假体置换后的早期步态比较[J].中国组织工程研究,2011,15(43):8023-8026.
[17]李军,李阳,荆珏华,等.华南地区正常成人股骨远端髁扭转角测量及其临床意义[J].中华关节外科杂志 (电子版),2013,7(3):26-28.