基于三维重建技术对国人胫骨近端截面形态学测量.docVIP

基于三维重建技术对国人胫骨近端截面形态学测量 　作者：李钰军，余斌，罗彪，周然，胡岩君，王博伟 【摘要】 ［目的］通过建立正常膝关节数字模型，测量胫骨近端不同截面线性参数，探讨性别及截骨厚度差异对胫骨假体基底部形态设计的影响。［方法］选取36例正常成人左侧膝关节，男女各半，年龄18～55岁，平均43岁；利用原始CT扫描图像资料重建膝关节，对胫骨近端进行模拟截骨，测量各截面内外侧前后径和横径。比较各测量值在性别间及截骨面间的差异。［结果］获取正常胫骨近端截面内外侧前后径、横径、前后径与横径的比值，内外侧前后径、横经、前后径与横径的比值在不同性别的差异具有统计学意义，内外侧前后径、前后径与横径的比值在不同截骨面高度的差异具有统计学意义。［结论］胫骨平台截面的几何形态不同于西方人，应用进口胫骨假体要考虑国人的特点；性别及胫骨截骨厚度会影响胫骨假体的设计和置换术中假体的选择。 【关键词】 全膝关节置换术； 胫骨近端截面； 假体； 性别 Measurement of proximal tibia in normal Chinese people with digital three-dimensional reconstruction technique∥LI Yu-jun, YU bin,LUO Biao，et al. Orthopaedic Department, Guangzhou Nanfang Hospital, Southern Medical University, Guangzhou ,510515, China Abstract: ［Objective］To obtain the normal linear parameters of different resection levels of normal proximal tibia in Chinese people, and discuss the influence of the gender and resection level on the design of the tibia prosthesis. ［Methods］Thirty-six normal Chinese people (36 left knees, 18 males and 18 females), with an average age of 43 years (range 18～55 years) were enrolled in this study.Original CT image data were used to set up three-dimensional model of Chinese normal knees.The related linear parameters of different proximal tibia sections were measured and compared.［Results］Parameters of mediolateral (ML) ,medial and latera anteroposteriordimensions(MAP/ LAP) and the aspect ratio(AP/ML) of the resect proximal tibia surface were obtained. The parameters were confirmed by statistics analysis.［Conclusion］The geometry and anatomy of the knee in Chinese people have significant differences from the western people.The prosthesis designed by western people should be choosen carefully.Sex and resection levels should be taken into account in designing tibia prosthesis and or choosing the imported prosthesis in the total knee arthroplasty. Key words：total knee arthroplasty; proximal tibia; prosthesis; sex; resection 人工关节假体和骨截面的吻合度是影响全膝关节置换的重要因素［1］。如果组件过小，容易导致假体下沉和松动［2］。2006年瑞典的一份调查报告显示1995年～2004年该国膝关节翻修的主