保留前后交叉韧带人工全膝关节假体的胫骨近端解剖测量  

Anatomical measurements of proximal tibia of anterior and posterior cruciate ligament-retaining knee prosthesis

作　　者：何沛恒[1] 徐栋梁[1] 左建伟[1] 李帅华[1] 瓦庆德[1] 

机构地区：[1]中山大学附属第一医院关节外科,广东省广州市510080

出　　处：《中国组织工程研究》2013年第26期4775-4781,共7页Chinese Journal of Tissue Engineering Research

基　　金：中山大学"5010"临床科研基金项目(2010005)~~

摘　　要：背景:目前使用的保留前后叉韧带的假体仍存在诸多问题。改良和设计保留前后交叉韧带膝关节假体相关的形态测量,特别是胫骨近端未曾见到过详细的报道和研究。目的:通过对正常膝关节三维数字化模型进行相关的胫骨近端形态学的分析,从而为改良和设计保留前后交叉韧带人工全膝关节假体提供参考。方法:40例正常志愿者进行膝关节的CT及MRI扫描,然后将膝关节CT、MRI断层影像数据导入Mimics10.01进行图像分割与三维重建,重建出完整的膝关节三维实体数字化模型后再导入Geomagic Studio11,在膝关节模型上测量前后交叉韧带在胫骨近端解剖参数,模拟截骨后测量胫骨近端截骨面的解剖参数。结果与结论:前后交叉韧带总的宽度为(14.94±2.56)mm,性别间比较提示男性需适当增加横向的截骨宽度以避免损伤前后交叉韧带。胫骨髁间棘顶部的长度为(8.02±1.03)mm,底部的长度为(15.19±1.71)mm,截骨后高度(9.13±0.88)mm,而且此梯形结构位于前后径48%-82%。胫骨截骨面内侧的内外径短于外侧的内外径,内侧前后径大于外侧的前后径,因而保留前后交叉韧带的假体更需要非对称性的设计。BACKGROUND： There are many problems with the present anterior and posterior cruciate ligament-retaining knee prosthesis. Morphological measurements to improve and design bi-cruciateligament-retaining knee prosthesis, particular in proximal tibia, were less seen in the literature. OBJECTIVE： To analyze the morphology of proximal tibia with three-dimensional digital models of knee joint, in order to provide reference for improving and designing bi-cruciate ligament-retaining knee prosthesis. METHODS： Forty volunteers were selected, and they were scanned with CT and MRI. The acquired image data were imported into computer for image segmentation and three-dimensional reconstruction by using MIMICS 10.01 software. Then three-dimensional digital models of the knee joint were imported into Geomagic Studio 11 software. By the knee joint models, the anatomical parameters of anterior and posterior cruciate ligaments on proximal tibia were measured. Also the anatomical parameters of the proximal tibial osteotomy surface were measured after simulation osteotomy. RESULTS AND CONCLUSION： The whole width of anterior cruciate ligament and posterior cruciate ligament was （14.94±2.56） mm, and the comparison between genders showed that transverse osteotomy width should be increased in male to avoid anterior and posterior cruciate ligament injury. The length of the top of the tibial spine, the base of the tibial spine and the height of the tibial spine were （8.02±1.03） mm, （15.19±1.71） mm and （9.13±0.88） ram, respectively. And the trapezoidal frame was located in the 48%-82% of the anteroposterior diameter. The mediolateral diameter of medial tibial osteotomy surface was smaller than that of lateral tibial osteotomy surface, however, the anteroposterior diameter of medial tibial osteotomy surface was larger than that of lateral tibial osteotomy surface, these results may imply that bi-cruciate ligament-retaining knee prosthesis need an asymmetric prostheses design.

关 键 词：骨关节植入物 人工假体 骨组织工程 膝关节假体 前后交叉韧带 胫骨髁间棘 胫骨近端截骨面 解剖测量 数字化模型 其他基金 

分 类 号：R318[医药卫生—生物医学工程]