胫骨后倾和半月板长度的相关性研究

发布时间：2018-07-14 10:37

【摘要】：背景:目前对膝关节半月板损伤的研究越来越多,但大多数研究都集中在半月板损伤的诊断及治疗方面,对半月板损伤的发生原因及损伤发生机制影响因素的研究较少,之前有文章研究了胫骨后倾和半月板后倾角度的关系,但还未有研究报道过胫骨后倾和半月板长度的关系。本课题从胫骨后倾和半月板的关系着手,对正常国人胫骨后倾角度和半月板长度进行了测量,并进行相关性分析,从而对今后进一步了解半月板损伤的危险因素,对膝关节假体模拟半月板功能的胫骨平台侧设计及半月板异体移植时半月板形态的选择提供指导。方法:本研究对25名男性和25名女性健康志愿者行右膝关节MRI扫描(平均年龄25.6±1.2岁),这些患者均否认既往膝关节疾病史及目前膝关节行走疼痛。扫描时志愿者体位为仰卧膝关节伸直0度中立位,扫描方向为轴位上垂直于股骨髁的穿髁线,矢状位平行于胫骨机械轴。在矢状位图像中测量内外侧胫骨平台的后倾角度,然后测量内外侧半月板前角及后角的厚度、水平长度和曲面长度。统计分析内外侧胫骨平台后倾角和内外侧半月板前后角厚度、水平及曲面长度的相关性。结果:内侧胫骨平台后倾角(n=50)平均值为7.86±2.73°,外侧胫骨平台后倾角(n=50)的平均值为7.47±3.14°。内侧半月板前角水平长度的平均值为13.61±2.05mm,内侧半月板后角水平长度平均值为22.18±2.44mm,内侧半月板前角厚度平均值为7.91±1.17mm,内侧半月板后角厚度平均值为8.73±1.43mm,内侧半月板前角曲面长度的平均值为15.51±1.12mm,内侧半月板后角曲面长度的平均值为22.36±0.47mm。外侧半月板前角水平长度平均值为15.86±2.06mm,外侧半月板后角水平长度平均值为17.43±3.84mm,外侧半月板前角厚度平均值为7.20±1.22mm,外侧半月板后角厚度的平均值为8.50±1.46mm,外侧半月板前角曲面长度的平均值为22.71±5.27mm,外侧半月板后角曲面长度平均值为17.90±0.37mm。内侧胫骨平台后倾角与内侧半月板后角水平长度明显相关(r=-0.409,P=0.025);但与内侧半月板前角厚度、水平及曲面长度、内侧半月板后角厚度和曲面长度不相关(P0.05);外侧胫骨平台后倾角与外侧半月板前后角的厚度、水平及曲面长度不相关(P0.05)。结论:随着内侧胫骨平台后倾角增大,内侧半月板后角水平长度随之减小。外侧胫骨平台后倾角与外侧半月板的各长度值不相关。此研究对于进一步了解半月板损伤的危险因素、膝关节假体模拟半月板功能的胫骨平台侧设计及半月板异体移植时半月板形态的选择都有重要的意义。
[Abstract]:Background: there are more and more researches on meniscus injury of knee joint at present, but most of the researches focus on the diagnosis and treatment of meniscus injury, and there are few researches on the cause and mechanism of meniscus injury. The relationship between tibial retroversion and meniscus backward angle has been studied before, but the relationship between tibia retroversion and meniscus length has not been reported. Based on the relationship between tibia retroversion and meniscus, the tibia angle and meniscus length of normal Chinese were measured, and the correlation analysis was carried out to further understand the risk factors of meniscus injury in the future. It provides guidance for the design of tibial plateau side of knee joint prosthesis simulating meniscus function and the choice of meniscus shape in meniscus allograft. Methods: in this study, right knee MRI scans were performed in 25 male and 25 female healthy volunteers (mean age 25.6 卤1.2 years). During the scanning, the volunteers were placed in the neutral position of 0 degree extension of the supine knee joint, the scanning direction was the axial position perpendicular to the femoral condyle, and the sagittal position was parallel to the mechanical axis of the tibia. The tilting angle of the tibial plateau was measured in sagittal images, and the thickness, horizontal length and curved surface length of the anterior and posterior angles of the medial and lateral meniscus were measured. The correlation between the posterior inclination angle of the tibial plateau and the thickness of the anterior and posterior angle of the lateral meniscus, the level and the length of the curved surface were analyzed statistically. Results: the average posterior inclination angle of medial tibial plateau was 7.86 卤2.73 掳, and that of lateral tibial plateau was 7.47 卤3.14 掳. The average horizontal length of the anterior horn of the medial meniscus is 13.61 卤2.05mm, the average horizontal length of the posterior horn of the medial meniscus is 22.18 卤2.44mm, the average thickness of the anterior horn of the medial meniscus is 7.91 卤1.17mm, the average thickness of the posterior horn of the medial meniscus is 8.73 卤1.43mm, and the average surface of the anterior angle of the medial meniscus is 8.73 卤1.43mm. The average length was 15.51 卤1.12mm and the average length of the posterior angle of medial meniscus was 22.36 卤0.47mm. The average horizontal length of the anterior horn of the lateral meniscus was 15.86 卤2.06mm, the average horizontal length of the posterior horn of the lateral meniscus was 17.43 卤3.84mm, the average thickness of the anterior horn of the lateral meniscus was 7.20 卤1.22mm, the average of the thickness of the posterior horn of the lateral meniscus was 8.50 卤1.46mm, the average of the lateral meniscus was 8.50 卤1.46mm. The average length of the lateral meniscus is 22.71 卤5.27mm, and the average length of the lateral meniscus is 17.90 卤0.37mm. The posterior inclination of the medial tibial plateau was significantly correlated with the horizontal length of the posterior angle of the medial meniscus (r = -0.409), but with the thickness of the anterior angle of the medial meniscus, the level and the length of the surface. The thickness of posterior angle of medial meniscus was not related to the length of surface (P0.05), and the posterior inclination angle of lateral tibial plateau was not correlated with the thickness, level and length of surface of lateral meniscus (P0.05). Conclusion: the horizontal length of the posterior angle of the medial meniscus decreases with the increase of the posterior inclination of the medial tibial plateau. The posterior inclination of lateral tibial plateau was not correlated with the length of lateral meniscus. This study is of great significance for further understanding the risk factors of meniscus injury, the design of tibial plateau for knee prosthesis to simulate meniscus function and the choice of meniscus shape in meniscus allograft.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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