膝外翻畸形相关三维形态学测量及临床意义  

Three-dimensional measurements of morphology of adult valgus knee and its clinical significance

作　　者：袁景[1] 宋焱峰[1] 王德贵[1] 高明暄[2] 李生贵[2] 

机构地区：[1]兰州大学基础医学院,甘肃兰州730000 [2]兰州军区总医院全军骨科中心,甘肃兰州730050

出　　处：《中国现代医学杂志》2015年第2期60-64,共5页China Journal of Modern Medicine

摘　　要：目的探讨成人膝外翻畸形的解剖形态学异常,为全膝关节置换术(TKA)提供解剖学依据。方法对41例(53膝)成人膝外翻畸形进行CT扫描,图像导入Mimics 10.01软件建立数字化三维模型,测量相关解剖参数,分析其分布规律及相关关系。将观察指标与健康正常膝(对照组n=41)进行比较。结果膝外翻术前X线片显示股胫角(FTA)(15.4±5.1)°,冠状面上测量股骨解剖轴与股骨远端关节面的外侧夹角(a LDFA)(76.6±1.2)°减小,胫骨解剖轴与胫骨近端关节面的内侧夹角(a MPTA)(95.8±0.5)°增大。CT显示通髁线与股骨髁远端关节面切线的夹角(DCA)(6.5±1.3)°增大,通髁线与股骨髁后方关节面切线的夹角(PCA)(5.2±1.2)°增大。以上测量指标与对照组比较,差异有统计学意义(P<0.05)。术中测量(DCA)(6.3±1.2)°、PCA(5.3±1.1)°、a LDFA(75.9±1.1)°、a MPTA(91.2±0.8)°,与术前影像测量值比较,差异无统计学意义(P>0.05)。结论该研究建立的膝关节数字化三维模型仿真度高,解剖参数测量结果精确度高,能为膝关节置换临床治疗和假体设计提供解剖学依据。【Objective】 To investigate the morphological anatomical abnormalities of valgus knee in adults and provide anatomical basis for the total knee arthroplasty. 【Methods】Tomographic images of 53 adult valgus knees were obtained by CT scan and imported into the Mimics 10.01 software for 3D reconstruction.Then the related anatomical parameters were measured and analyzed.【Results】X-ray showed preoperative femur-tibia angle [FTA,（15.4 ± 5.1） °], anatomical lateral distal femoral angle [ a LDFA,（76.6 ± 1.2） °] decreased, anatomical medial posterior tibia angle [ a MPTA,（95.8 ± 0.5） °] increased. CT showed distal condylar angle [ DCA,（6.5 ± 1.3） °] increased, poster condylar angle [ PCA,（5.2 ± 1.2） °] increased. There were statistically significant differences in the morphological parameters between the two groups（P〈0.05）. Intraoperative measurements were DCA（6.3 ± 1.2） °, PCA（5.3 ± 1.1） °, a LDFA（75.9 ± 1.1） °, a MPTA（91.2 ± 0.8） ° compared with the preoperative imaging measurements. There was no statistically significant difference between intraoperative measurements and preoperative measurements（P〈0.05）. 【Conclusion】The three-dimensional reconstruction model has a high fidelity and a high accuracy in anatomical measurement. It can provide anatomical references in the clinical managements and knee prosthesis of adult valgus knee.

关 键 词：膝外翻 三维重建 解剖变异 形态学参数 

分 类 号：R682.6[医药卫生—骨科学]