年龄对股骨形态参数影响100例测量分析:对假体选择及设计的意义  

Analysis of age influence on the morphology parameters of the femur in 100 cases: Significance in prosthesis selection and design

作　　者：喻飞[1] 李强[1] 杨波[1] 王志义[1] 

机构地区：[1]首都医科大学骨外科系,首都医科大学北京友谊医院骨科,北京市100050

出　　处：《中国组织工程研究与临床康复》2009年第39期7627-7631,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:研究证实,人工关节假体稳定性是和假体与髓腔的匹配密切相关的。但髓腔形态和髓腔直径是否随年龄而改变,最终影响假体和髓腔的远期匹配,尚未见专门而系统的报道。目的:了解年龄对股骨髓腔形态和几何参数的影响。观察股骨髓腔形态或径长随年龄变化的趋势,试图据此指导假体的选择和术中操作,提高假体的远期生存率。设计、时间及地点:形态学水平的对比观察,于2007-08/2008-04在首都医科大学北京友谊医院骨科完成。对象:在骨科门诊抽取北京地区健康男、女老年人共100名,对试验方案均知情同意。方法:采用美国PICKER2000螺旋CT机对100名观察对象进行左股骨全长扫描,扫描条件是150kV,100mA。主要观察指标:测量内容包括被测量人群的一般参数、股骨的外部形态参数、股骨髓腔径长参数和股骨髓腔形态参数,共计36个参数。结果:随年龄增长,在描述股骨外部形态的参数、髓腔形态的参数和股骨髓腔径长参数中,峡部的位置在各组之间差异具有显著性意义(P<0.05)。男、女分别按照年龄分组后,女性峡部前、后方的皮质厚度及峡部的前后径差异有显著性意义(P<0.05);男性所有参数在各个年龄组差异均无显著性意义(P>0.05)。结论:就假体设计而言,不论男性还是女性,不需要随年龄的增加而改变假体的形态设计,对于老年女性,假体柄的长度可以适当加长,在手术中及假体的选择上更应该注意假体近端和髓腔的匹配,假体的选择似乎以采用近端固定为好。BACKGROUND： Studies have shown that stability of artificial joint prosthesis is highly correlated with medullary cavity matching. However, whether medullary cavity appearance and diameter changes with age, ultimately affecting prosthesis and medullary cavity match remains unclear. OBJECTIVE： To evaluate the effect of age on femoral medullary cavity morphology and geometric parameters, and observe medullary cavity changes with age so as to guide prosthesis selection and operation and improve long-term survival of prosthesis. DESIGN, TIME AND SETTING： Comparative observation of morphology. The experiment was performed at the Department of Orthopedic Surgery, Beijing Friendship Hospital Affiliated to Capital Medical University from August 2007 to April 2008. PARTICIPANTS： A total of 100 healthy female and male people were selected from Orthopedics Outpatient Department. Informed consent was obtained from all subjects. METHODS： All patients underwent a left full-length femoral CT scanning, 150 kV, 100 mA. The images were reconstructed and measured at the PICKER 2000 Voxel Q station. MAIN OUTCOME MEASURES： The contents of 36 data collected from the patients included general information of the patients, the external parameters of femur, radius-length parameters of femoral medullary cavity and morphological parameters of femoral medullary cavity. RESULTS： Among all femoral parameters, the site of isthmus altered significantly with aging （P 〈 0.05）. The anterior and posterior cortical thicknesses of isthmus and medullar anteroposterior diameters of isthmus changed significantly with age in female group （P 〈 0.05）, but were not changed significantly in male group （P 〉 0.05）. CONCLUSION： As for the prosthetic design, the shape design of prosthesis needs not to change with aging for male or female. Properly lengthening the femoral stem will help to get best fit of prosthesis. Proximally fixed femoral prosthesis seems to have superiority theoretically for elderly female patient

关 键 词：股骨近端 髓腔形态 髓腔径长 年龄 

分 类 号：R318[医药卫生—生物医学工程]