中国汉族成人股骨髁部分形态学参数测量及与下肢长度的相关性研究  

Measurement of partial morphology on femoral condyle in Chinese Han nationality and analysis of correlation with leg length

作　　者：赵潇雄 曲铁兵[1] 马德思 潘江[1] 林源[1] 张博[1] 温亮[1] 辛星[2] 王志为[1] 陈彤[1] 

机构地区：[1]首都医科大学附属北京朝阳医院骨科,100020 [2]北京大学国际医院骨科,102206

出　　处：《中华关节外科杂志（电子版）》2015年第6期73-81,共9页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的测量中国汉族人群股骨内外髁相关参数,并通过回归分析探究其与下肢长度的关系,为国人膝关节假体的设计以及膝关节手术提供参数依据。方法采集多中心标本。2012年10月至2013年7月,对北京、河北、新疆及重庆的186例健康成年汉族志愿者行双下肢全长CT扫描,共获得372个正常膝关节图像数据纳入研究。其中男93例,女93例;年龄17~65岁（平均36.3岁）;左右侧各186膝。通过垂直于股骨机械轴线的断层图像,在Mimics软件下进行测量,观察指标包括股骨内髁前后径、股骨外髁前后径、股骨内髁高度、股骨外髁高度、股骨外髁倾角、股骨内髁倾角、下肢长度,并计算内外髁高度差及内外髁联合倾角。按性别和侧别分组,进行独立样本t检验差异性分析;并将测量的前后径、高度及倾角与下肢力线长度进行相关性及回归分析。结果股骨外髁高度为（62.5±4.3）mm,内髁高度为（58.8±4.4）mm,股骨内、外髁倾角[（76.7±2.3）°,（88.7±2.1）°]。不同性别间下肢力线长度、内、外髁高度及内外、髁前后径的差异有统计学意义（t值分别为17.712、10.950、11.570、10.656和10.405,P〈0.05）,而侧别间上述测量数据无统计学差异（P〉0.05）。在男女人群中,下肢力线长度与内外髁高度及内外髁前后径呈正相关（r分别为0.741、0.753、0.729、0.720）,其余则无明显相关性（r〈0.1）。在回归分析之后,得出内外髁高度及内外髁前后径相对于下肢力线长度的线性关系,并发现不同性别间,内外髁高度及内外髁前后径的变化程度不同。结论通过对较大样本多中心中国汉族人群正常膝关节影像学测量,得到相对准确的汉族人群股骨内外髁高度、内外髁前后径、内外髁倾角及与下肢力线长度的关系,可以为国人假体设计提供参考,提高膝关节股骨假体的匹配度,同时为膝关节置换手术提供了相关依据。Objective To explore the relationship between the parameters of medial and lateral femoral condyle and the leg length in Chinese Han nationality by measurements and regression analysis,guide Chinese prosthesis design and provide data basis for total knee arthroplasty（ TKA）. Methods The multi-center samples were used. CT scans on 372 normal knees（ 186 left and 186 right knees,93 males and 93 females,from Beijing,Xinjiang,Hebei,Chongqing） were studied from 2012. 10 to 2013. 7. We measured with Mimics on the tomography perpendicular to the mechanical alignment. Anteroposterior diameter of medial and lateral femoral condyles（ APMFC,APLFC）,height of medial and lateral femoral condyles（ HMFC,HLFC）,angles of medial and lateral femoral condyles（ AMFC,ALFC） and length of lower limb alignment were measured; the height between medial and lateral femoral condyles（ HMLFC）and the angle between medial and lateral femoral condyles（ AMLFC） were calculated. The differences were compared between the genders and sides by independent t-test,and the relationship was analyzed using correlation analysis and regression analysis. Results HMFC was（ 62. 5 ± 4. 3） mm,HLFC was（ 58. 8 ±4. 4） mm. AMFC was（ 76. 7 ±2. 3） °,ALFC was（ 88. 7 ±2. 1） °. There was significant difference between genders in terms of APMFC,APLFC,AMFC,ALFC（ t = 17. 712,10. 950,11. 570,10. 656 and 10.405,P〈0. 05）. No significant difference was found between different sides in all the observation items（ P〈0. 05）. APMFC,APLFC,HMFC and HLFC positively related to the length of lower limbs alignment by the correlation study. The linear relationships between the leg length and HMFC,HLFC,APMFC,APLFC were also found by regression analysis. These parameters varied between genders. Conclusion With a large number of multi-center samples for investigating the relationship between the APMFC,APLFC,HMFC,HLFC,ALFC,AMFC and the leg length in Han nationality,the results are relatively accurate,and the data will give a good directi

关 键 词：假体设计 膝关节 解剖学 组织学 

分 类 号：R816.8[医药卫生—放射医学]