骨性关节炎胫骨近端解剖形态性别差异及临床意义

发布时间：2018-06-15 21:33

本文选题：胫骨 + 骨性关节炎　；参考：《中国矫形外科杂志》2017年23期

【摘要】：[目的]分析骨性关节炎患者胫骨近端截骨面各解剖参数的性别差异,为国产人工膝关节胫骨假体的设计提供依据。[方法]对116例(男58例,女58例)汉族骨性关节炎患者膝关节CT扫描图像进行三维重建。胫骨外侧平台下10 mm、后倾7°行胫骨近端截骨,测量胫骨平台内外径(ML)、胫骨平台中部前后径(AP)、胫骨内侧平台前后径(MAP)、胫骨外侧平台前后径(LAP),计算ML/AP比值,根据AP(48 mm,48~52 mm,52 mm)将ML/AP分为三组,比较胫骨近端截骨面各参数的性别差异。[结果]男性胫骨近端截骨面各解剖参数均大于女性,差异有统计学差异(P0.001)。胫骨近端ML/AP与AP呈负相关,随着AP的增大ML/AP减小,并且在相同的AP值下,男性胫骨ML/AP大于女性,显示一个给定AP尺寸假体,男性胫骨ML有可能会覆盖不全,女性悬空。[结论]胫骨近端截骨面男性和女性存在尺寸和形态的差异。在设计胫骨假体时,ML/AP应该考虑作为参考设计性别差异性胫骨假体。
[Abstract]:[objective] to analyze the gender differences of anatomical parameters of proximal tibia osteotomy in patients with osteoarthritis, and to provide basis for the design of tibial prosthesis made in China. [methods] three dimensional reconstruction of knee joint was performed in 116 patients with osteoarthritis of Han nationality (58 males and 58 females). The proximal tibial osteotomy was performed at 10 mm below the lateral tibial plateau and 7 掳backward tilting. The internal and external diameters of the tibial plateau were measured, the anterior and posterior diameters of the tibial plateau were measured, the anterior and posterior diameters of the medial tibial plateau were MAPP, and the anteroposterior and posterior diameters of the lateral tibial plateau were calculated to calculate the MLP / AP ratio. MLP / AP was divided into three groups according to APL 48mm / 48mm / 52mm. The parameters of proximal tibia osteotomy were compared by sex. [results] the anatomical parameters of proximal tibial osteotomy in male were higher than that in female (P 0.001). MLP / AP in proximal tibia was negatively correlated with AP. MLP / AP decreased with the increase of AP. Under the same AP value, MLR / AP of male tibia was larger than that of female, indicating that a prosthesis with a given AP size might not cover male tibia completely, while female tibia might be suspended. [conclusion] the size and morphology of proximal tibia osteotomy are different between male and female. MLR-AP should be considered as a reference for the design of different tibial prostheses.
【作者单位】：北京大学第三医院运动医学研究所;陕西省人民医院骨科;
【基金】：国家自然科学基金仪器专项项目(编号:81327001) 国家国际科技合作专项资助项目(编号:2011DFA31340) 北京市科学技术委员会“首都市民健康培育项目”(编号:Z131100005213004) 陕西省自然基金项目(编号:2017JM8154)
【分类号】：R684.3

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