膝大骨节病胫骨近端解剖形态三维CT测量及其临床意义  

Three Dimensional Morphometry Measurement of Proximal Tibia Anatomy in KBD Population and Its Clinical Significance

作　　者：杨波[1] 凌鸣[1] 常彦海[1] 刘慧通[1] 强辉[1] 陶剑[2] 

机构地区：[1]陕西省人民医院骨科 [2]黄龙县人民医院放射科

出　　处：《中国数字医学》2017年第6期76-78,共3页China Digital Medicine

基　　金：陕西省社会发展科技攻关(编号:2016SF-219);陕西省卫生厅重大科研基金(编号:2012A1)~~

摘　　要：目的:通过三维CT测量适合行全膝关节置换术(TKA)的大骨节病患者胫骨近端解剖形态参数,为行TKA的大骨节病胫骨假体的设计提供参考依据。方法:选取适合TKA的大骨节病和正常国人各46例进行膝关节CT扫描,用Mimics进行三维重建并测量胫骨平台横径(ML)、胫骨平台中部前后径(AP)、胫骨内侧平台前后径(MAP)、胫骨外侧平台前后径(LAP),并计算ML/AP比值,比较胫骨近端各解剖形态参数差异。结果:大骨节病组胫骨近端各解剖参数测量值(ML、AP、MAP、LAP)均小于正常国人膝关节组,差异有统计学差异(P<0.01)。大骨节病胫骨近端ML/AP比值明显大于正常膝关节组,显示一个给定AP的胫骨假体,大骨节病胫骨近端ML有可能会覆盖不全,正常膝关节有可能会悬空。结论:适合TKA治疗的大骨节病膝关节胫骨近端解剖形态与正常膝关节存在一定差异,为设计适合大骨节病的TKA的人工胫骨假体,提高TKA精确度与临床疗效提供理论依据。Objective： The objective of this study was to measure and analyze morphologic feature of proximal tibial in Kaschin-Beck disease knees which fit for total knee arthroplasty（TKA） and its clinical significance. Methods： 46 KBD and 46 normal knees） were measured by three dimensional CT for the proximal tibial mediolateral （ML）, middle anteroposterior （AP）, medial anteroposterior （MAP）, lateral anteroposterior （LAP） dimensions and ML/AP aspect ratio to compared the differences of proximal tibia between KBD and normal knees. Results： There were significant differences between KBD and normal knees in relation to ML, AP, MAP and LAP dimensions （P〈0.01）. We also found that KBD have larger ML/AP aspect ratio than that of normal knees under a given AP dimension （P〈0.01）. This means that under a given AP dimension component, the tibial ML dimension tended to undersized in KBD and to overhang in normal knees. Conclusion： Proximal tibia showed significant differences in the size and shape between KBD and normal knees. The results of this study can provide important theoretical basis in designing proper tibia prosthesis, improving the accuracy and clinical efficacy of TKA for KBD population.

关 键 词：大骨节病 胫骨 形态学 全膝关节置换术 三维重建 

分 类 号：R684[医药卫生—骨科学] R445[医药卫生—外科学]