骨性关节炎胫骨近端解剖形态性别差异及临床意义  

Gender differences in morphometry of resected proximal tibia surface in total knee arthroplasty for osteoarthritic knees

作　　者：杨波[1,2] 黄爱兵[1] 宋长辉[1] 凌鸣[2] 余家阔[1] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100191 [2]陕西省人民医院骨科,西安710068

出　　处：《中国矫形外科杂志》2017年第23期2173-2176,共4页Orthopedic Journal of China

基　　金：国家自然科学基金仪器专项项目(编号:81327001);国家国际科技合作专项资助项目(编号:2011DFA31340);北京市科学技术委员会"首都市民健康培育项目"(编号:Z131100005213004);陕西省自然基金项目(编号:2017JM8154)

摘　　要：[目的]分析骨性关节炎患者胫骨近端截骨面各解剖参数的性别差异,为国产人工膝关节胫骨假体的设计提供依据。[方法]对116例(男58例,女58例)汉族骨性关节炎患者膝关节CT扫描图像进行三维重建。胫骨外侧平台下10 mm、后倾7°行胫骨近端截骨,测量胫骨平台内外径(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),计算ML/AP比值,根据AP(<48 mm,48~52 mm,>52 mm)将ML/AP分为三组,比较胫骨近端截骨面各参数的性别差异。[结果]男性胫骨近端截骨面各解剖参数均大于女性,差异有统计学差异(P<0.001)。胫骨近端ML/AP与AP呈负相关,随着AP的增大ML/AP减小,并且在相同的AP值下,男性胫骨ML/AP大于女性,显示一个给定AP尺寸假体,男性胫骨ML有可能会覆盖不全,女性悬空。[结论]胫骨近端截骨面男性和女性存在尺寸和形态的差异。在设计胫骨假体时,ML/AP应该考虑作为参考设计性别差异性胫骨假体。[Objective] To investigate the morphologic features of resected proximal tibia surface in total knee arthroplasty （TKA） for osteoarthritic knees and find out the differences between the men and women. [Method] A total of 118 osteoarthritic knees （58 from men, 58 from women） received computed tomography measurement for the proximal tibia] mediolateral （ML）, middle anteroposterior （AP）, medial anteroposterior （MAP）, lateral anteroposterior （LAP） dimensions and ML/AP ratio. Then the ML/AP was divided into 3 groups based on the different AP dimensions （〈48 ram, 48-52mm, 〉52mm） to find out the differences of reseeted proximal tibia surface between men and women. [Result] Significant differences were found between the men and women in terms of ML, AP, MAP and LAP dimensions （P〈0.01）. As increasing of AP dimension, the ML/AP ratio decreased, with a negative correlation between them （P〈0.005） . in the same AP dimension condition, a higher ML/AP ratio was noted in men and a lower ML/AP ratio in women. The results demonstrated that under a given AP dimension prosthesis, the tibia] ML di- mension could be undersized in men, conversely overhang in women. [Conclusion] Proximal tibia showed significant differenc- es in the size and shape between men and women. The results of this study can provide important reference in designing proper gender-specific tibia prosthesis with different ML/AP aspect ratio in clinics.

关 键 词：胫骨 骨性关节炎 形态 全膝关节置换术 性别 

分 类 号：R684.3[医药卫生—骨科学]