同种异体半月板移植尺寸匹配的解剖研究  

Meniscal Allograft Sizing by the Measurement of the Meniscus and Tibial Plateau——A Cadaveric Study

作　　者：罗浩[1] 龚熹[1] 陈连旭[1] 江东[1] 王海军[1] 张继英[1] 余家阔[1] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100191

出　　处：《中国运动医学杂志》2012年第2期119-123,共5页Chinese Journal of Sports Medicine

基　　金：北京大学第三医院院内重大课题(BYSY200909);北京大学"985"Ⅱ期项目(985-2-028-24)

摘　　要：目的:通过解剖测量成人尸体半月板和胫骨尺寸,研究半月板移植进行供体和受体尺寸匹配时,半月板尺寸与胫骨尺寸之间的关系,以判断通过测量胫骨尺寸而计算得出准确半月板尺寸的可行性。方法:对25～45岁的8具成人新鲜尸体的16个膝关节(左膝8个,右膝8个)进行解剖。测量每个膝关节内、外侧半月板的长度和宽度,胫骨内、外侧平台的长度和宽度。对半月板和胫骨平台的测量结果进行比较,并对测量结果进行统计学分析和线性回归分析。对于同一个膝关节,根据回归公式,通过胫骨平台的测量尺寸计算得出理论半月板的尺寸,再将理论半月板的尺寸与实际半月板的测量结果进行比较,得出理论半月板尺寸与实际半月板尺寸误差小于5%的比例。P<0.05定义为具有显著性差异。结果:测量的16个膝关节的内侧半月板宽度为(29.2±2.1)mm,内侧胫骨平台宽度(33.8±2.1)mm,P<0.001;内侧半月板的长度(39.8±4.1)mm,内侧胫骨平台长度(50.6±2.0)mm,P<0.001;外侧半月板宽度(30.9±2.2)mm,外侧胫骨平台宽度(33.7±1.6)mm,P<0.001;外侧半月板长度(33.3±2.5)mm,外侧胫骨平台长度(46.8±2.5)mm,P<0.001。根据半月板尺寸与胫骨平台尺寸之间的线性回归公式,计算所得的理论半月板尺寸比同一膝关节半月板实际解剖测量尺寸误差小于5%的符合率为:内侧半月板宽度50%,内侧半月板长度31.25%,外侧半月板宽度75%,外侧半月板长度56.25%。结论:在半月板移植前进行受体和供体半月板尺寸匹配时,不能通过测量患者胫骨平台的尺寸代替所需要半月板移植物的尺寸。通过本研究16例膝关节半月板尺寸与胫骨尺寸之间的线性回归公式不能获得理想的半月板移植物尺寸。Objective To investigate the relationship between the size of meniscus and tibial plateau and to estimate the feasibility of calculating the accurate size of meniscus from the size of tibial plateau.Methods Sixteen fresh frozen cadaveric knees,aged 25 to 45 years,were dissected.There were 8 left knees and 8 right knees.The width and the length of the medial and lateral meniscus,the medial and lateral tibial plateau were measured.The measured data（mean ± standard deviation） were statistically evaluated and compared.The linear regression analysis was applied for each pair of data of the meniscus and the tibial plateau.According to this linear relationship,the theoretic size of the meniscus could be calculated by the size of the tibial plateau,and then the theoretic size and the actually measured size of the meniscus were compared.The accuracy was defined as the error of those theoretic sizes that fell within 5% of the actual sizes.The number of accurate theoretic size of the meniscus in every item could be obtained.Results The width of the medial meniscus（WMM） and the medial tibial plateau（WMT） were（29.2±2.1）mm and（33.8±2.1）mm（P〈0.001）,respectively.The length of the medial meniscus（LMM） and the medial tibial plateau（LMT） were 39.8±4.1mm and（50.6±2.0）mm（P〈0.001）,respectively.And the width of the lateral meniscus（WLM） and the lateral tibial plateau（WLT） were（30.9±2.2）mm and（33.7±1.6）mm（P〈0.001）,respectively.The length of the lateral meniscus（LLM） and the lateral tibial plateau（LLT） were（33.3±2.5）mm and（46.8±2.5）mm（P〈0.001）,respectively.Although there were correlations between WMM and WMT,LMM and LMT,WLM and WLT,LLM and LLT,the accuracy for the derived linear regression formulas was 50%,31.25%,75%,56.25%,respectively.Conclusion The theoretic size of meniscus calculated by the size of tibial plateau is not accurate.Consequently,it is not feasible to obtain the accurate size of the meniscus from the size of the tibial platea

关 键 词：半月板 尺寸 移植 解剖 膝关节 

分 类 号：R87[医药卫生—运动医学]