国人髌骨解剖标志点在髌骨置换截骨中意义  

Significance of anatomic characters of patella in Chinese during total knee arthroplasty

作　　者：张磊[1] 刘忠堂[1] 李彬 林祥波[1] 钱齐荣[1] 吴宇黎[1] 吴海山[1] 

机构地区：[1]上海长征医院骨科,上海市200003

出　　处：《中国组织工程研究与临床康复》2008年第17期3241-3244,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:全膝置换中进行正确的髌骨截骨是减少置换后髌骨并发症的重要因素,实验利用正常国人髌骨解剖标志点,探讨其在国人髌骨置换髌骨截骨中的意义。方法:实验于2006-06/2007-01在上海长征医院关节外科完成。①实验材料:成人尸体50膝(由解放军第二军医大学提供)。②实验过程:采用标准的膝关节正中皮肤切口入路打开关节腔,外翻髌骨,测量髌骨厚度,暴露髌腱外缘髌骨止点及股四头肌内、外缘的髌骨止点,美兰标记,由同一位医师利用摆锯截骨。③评估:测量截骨前髌骨厚度及截骨后残存髌骨厚度。结果:髌骨截骨前平均厚度为(23.39±1.19)mm,残存髌骨的平均厚度为(13.83±1.04)mm,大于12mm的要求(文献报道的国人髌骨截骨术后残余厚度应大于12mm,P<0.05)。结论:利用髌腱外缘及股四头肌内、外缘作为截骨的解剖标志点进行国人的髌骨截骨,残余髌骨厚度满足髌骨假体置换的要求,是适合国人解剖特点的髌骨截骨标志点。AIM： Accurate patellar resection in total knee arthroplasty can reduce patellar complications after surgery. This study explored the anatomic characters in freehand resection of the patella during total knee arthroplasty in Chinese. METHODS： The experiment was performed at Department of Joint Surgery, Shanghai Changzheng Hospital from June 2006 to January 2007. Fifty patellae of adult cadavers were provided by Second Military Medical University of Chinese PLA. Articular cavity was exposed by standard knee medial incision. Patella was resected with saw using three marks： the lateral attachment of the patella tendon distally and the two edges of the quadriceps tendon proximally. The patellar thickness was measured pre- and post-resection. RESULTS： The mean thickness of patella was （23.39±1.19） mm before resection, and （13.83±1.04） mm after resection, which met the demand of 12 mm for patellar resurfacing arthroplasty during total knee arthroplasty in Chinese （P 〈 0.05）. CONCLUSION： The three marks （lateral attachment of the patella tendon distally and the two edges of the quadriceps tendon proximally） are safe to be used in freehand resection of the patella in Chinese.

关 键 词：髌骨 解剖标志 关节成形术 置换 组织构建 

分 类 号：R681[医药卫生—骨科学]