体重负荷下正常胫股关节6个自由度的运动学  

Kinematics of normal tibio-femoral joint on six degrees of freedom during weight-bearing flexion

作　　者：陈凯宁[1] 傅德杰[1] 陈诚[1] 程良骏[2] 尹力[1] 郭林[1] 杨柳[1] 

机构地区：[1]第三军医大学西南医院关节外科,重庆400038 [2]第三军医大学西南医院放射科,重庆400038

出　　处：《中国矫形外科杂志》2013年第7期684-689,共6页Orthopedic Journal of China

基　　金：国家自然科学基金(编号:31070837)

摘　　要：[目的]定量分析正常胫股关节在体重负荷下6个自由度的运动学特征。[方法]双平面X线摄取10名健康志愿者一侧膝关节从伸直位到120°屈曲多角度下应力位的二维影像。螺旋CT扫描同一侧膝关节,并用获取的影像重建成三维模型。应用三维模型配准二维影像的方法测出股骨相对于胫骨全自由度的运动学数据。[结果]从伸直位到120°屈曲过程中,股骨后移(5.1±2.3)mm,外移(3.1±1.8)mm,远移(4.1±1.2)mm,外旋(17.3±6.9)°;股骨基本处于内翻(3.9±2.2)°;股骨外侧髁后移(12.6±3.4)mm,内侧髁前移(0.4±3.9)mm。[结论]正常膝关节在体重负荷下屈曲过程中,股骨相对于胫骨发生后移、外移、远移和外旋,内翻变化小;股骨内外侧髁的运动有差别。[ Objective] To quantitatively analyze the kinematics of normal tibio- femoral joint on six degrees of freedom during weight - bearing flexion. [ Methods] The two - dimensional （2D） knee images of ten healthy subjects were captured by biplane radiography during a knee bending activity from extension to 120°. Next, the same knee was scanned by spiral CT, and the three - dimensional （3D） knee model was created using CT data. The 3D to 2D image matching technique was used to meas- ure the kinematics of the femur relative to the tibia. [ Results] On flexion from extension to 120°, the femur moved posteriorly by （5.1 ± 2. 3） mm, laterally by （3.1 ± 1.8） mm, distally by （4. 1 ± 1.2） mm on the tibia. The femur rotated externally by （ 17. 3 ±6. 9）°, and was almost in adduction by （3.9 ±2. 2）° with increasing flexion. In addition, the lateral femoral condyle moved backwards by （ 12. 6 ± 3.4） mm, while the medial condyle moved forwards by （0. 4 ± 3.9） mm during flexion. [ Conclusion] As the normal knee flexed during weight- bearing condition, the femur showed posterior, lateral and distal movement and external rotation relative to the tibia. And the femoral adduction altered shghtly. A difference was found between the movement of the medial and lateral femoral condyles.

关 键 词：膝关节 运动学 双平面X线片 图像配准 

分 类 号：R687.3[医药卫生—骨科学]