膝外翻畸形全膝关节置换的假体匹配:三维模型数字化测量与分析  

Prosthetic matching of knee valgus for total knee arthroplasty: three-dimensional digital measurement and analysis

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

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

出　　处：《中国组织工程研究》2015年第17期2768-2774,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:膝外翻畸形常需人工全膝关节置换来矫形,人工全膝关节置换选用假体与膝关节相匹配程度明显影响置换后长期效果。目前国内使用率较高的仍然是依据西方人数据设计的假体系统,应用于国人往往达不到最好匹配。目的:探讨股骨髁及胫骨平台的解剖形态学异常,为膝外翻畸形的全膝关节置换提供解剖学数据。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,分析其分布规律与相关关系。将膝关节相关参数与单膝畸形患者的健侧正常膝(对照组29膝)进行比较。结果与结论:膝外翻畸形X射线片显示股胫角为(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(76.6±1.2)°减小,胫骨解剖轴与胫骨近端关节面的内侧夹角(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(6.5±1.3)°增大、通髁线与股骨髁后方关节面切线的夹角通髁线与股骨髁后方关节面切线的夹角(5.2±1.2)°增大。以上测量指标与对照组比较,差异有显著性意义(P<0.05)。提示在膝外翻畸形全膝关节置换中,应注意股骨髁和胫骨平台的解剖学异常。BACKGROUND： Knee valgus deformity often needs total knee arthroplasty. The choice of prosthesis in total knee arthroplasty significantly affects the long-term effects. The currently used prosthesis is designed based on the data of western countries, which cannot well match with Chinese data. OBJECTIVE： To observe the abnormality of anatomical morphology of the femoral condyle and tibial plateau, and provide anatomical data for total knee arthroplasty in treatment of knee valgus deformity. METHODS： 41 adult patients （53 knees） with knee valgus deformity were detected with CT scan, the obtained images were imported into Mimics 10.01 software, and digital three-dimensional model was established. The anatomical parameters were measured, and the distribution and correlation were analyzed. The knee joint parameters between knee valgus deformity patients and health, normal knee in single deformity patients （control group, n=29） were compared.RESULTS AND CONCLUSION： X-ray findings showed that, tibiofemoral angle of knee valgus was （15.4±5.1）°, anatomical lateral distal femoral angle at coronal plane （76.6±1.2）° was decreased, and anatomical medial posterior tibia angle （95.8±0.5）° was increased. CT findings showed that, the distal condylar angle （6.5±1.3）° was increased, the poster condylar angle （5.2±1.2）° was also increased. There were significant differences compared with the control group （P 〈 0.05）. In the total knee arthroplasty of knee valgus deformity, anatomical abnormality of femoral condyle and tibial plateau should be noted.

关 键 词：膝外翻 关节成形术 置换 膝 成像 三维 解剖学 植入物 数字化骨科 全膝关节置换 三维重建 解剖变异 形态学参数 数字化模型 假体匹配 相关性分析 

分 类 号：R318[医药卫生—生物医学工程]