正常成人膝关节X线测量在膝关节假体设计中的意义  

Significance of normal adult knee measurement in the design of total knee arthroplasty prosthesis

作　　者：陈勇[1] 杨姣 刘杰[1] 王梦柯 邓小龙 戴思宇 丁建平[4] CHEN Yong;YANG Jiao;LIU Jie;WANG Meng-ke;DENG Xiao-long;DAI Si-yu;DING Jian-ping(Department of Radiology,The Affiliated Hospital of Hangzhou Normal University,Zhejiang 310015,China)

机构地区：[1]杭州师范大学附属医院医学影像科,浙江杭州310015 [2]西安医学院第二附属医院医学影像科,陕西西安710061 [3]淳安县第二人民医院放射科,浙江杭州311719 [4]杭州师范大学临床医学院,浙江杭州310018

出　　处：《影像诊断与介入放射学》2022年第5期364-369,共6页Diagnostic Imaging & Interventional Radiology

基　　金：浙江省医药卫生科技计划项目(2022KY962);杭州市医药卫生科技项目(2021123Y029);杭州市生物医药和健康产业发展扶持科技专项(2021WJCY053)。

摘　　要：目的测量正常成人膝关节的各项数值,为全膝关节置换假体设计提供数据参考。方法搜集1143例(男:女为569:574)正常成人膝关节正侧位DR X线片,分成四组,A组:25~29岁(212例),B组:30~39岁(310例),C组:40~49岁(330例),D组:50~59岁(291例),测量相关角度、长度及间隙。结果对1143例膝关节进行测量,获得各指标均值如下:股骨远端外侧角为83.13°,胫骨近端外侧角为92.12°,股胫角为175.74°,股骨髁干角为98.82°,股骨内外侧髁横径为7.95 cm,胫骨平台横径为7.61 cm,膝关节内侧间隙为0.53 cm,外侧间隙为0.51 cm。经统计分析发现膝关节股胫角、股骨内外侧髁横径、胫骨平台横径及膝关节内外侧间隙在性别方面具有统计学差异(P<0.05),女性小于男性。胫骨近端外侧角、股胫角在侧别方面具有统计学差异(P<0.05),左侧小于右侧;膝关节内、外侧间隙在侧别方面具有统计学差异(P<0.05),右侧小于左侧。股骨内外侧髁横径、胫骨平台横径、股骨髁干角、股骨远端外侧角及膝关节内、外侧间隙在不同年龄组之间存在统计学差异(P<0.05)。结论在进行膝关节置换假体设计时应依据国内数据,应充分考虑人种、性别、侧别和年龄组之间的差异。Objective To measure the values of normal knee joints and provide data reference for the design of total knee arthroplasty prosthesis in the Chinese population.Methods A total of 1143(569 men,574 women)participants were divided into four age groups of A(212,25-29 years),B(310,30-39 years),C(330,40-49 years),and D(291,50-59 years).The joint angles,lengths and spaces were measured on the digital radiography images.Results In 1143 knee joints,the mean lateral angle of distal femur was 83.13°,the lateral angle of proximal tibia was 92.12°,the femoral tibial angle was 175.74°,the femoral condylar shaft angle was 98.82°,the transverse diameter of medial and lateral femoral condyles was 7.95 cm,the transverse diameter of tibial plateau was 7.61 cm,the medial knee joint space was 0.53 cm,and the lateral space was 0.51 cm.Statistical analysis showed that the femoral tibial angle,the transverse diameter of medial and lateral femoral condyles,the transverse diameter of the tibial plateau,and the medial and lateral joint spaces were significantly smaller in women than men(P<0.05).The lateral angle of proximal tibia and femoral tibial angle were significantly smaller on the left than the right(P<0.05).There were significant differences between the medial and lateral knee joint spaces(P<0.05),and the right was smaller than the left side.There were also significant differences in the transverse diameters of medial and lateral femoral condyles,transverse diameters of tibial plateaus,femoral condyle shaft angles,distal femoral lateral angles,and the medial and lateral joint spaces between different age groups(P<0.05).Conclusion Knee arthroplasty prosthesis design should be based on national data,and should fully account for differences between race,sex,side,and age groups.

关 键 词：膝关节 正常值 膝关节置换 膝关节假体 

分 类 号：R322.72[医药卫生—人体解剖和组织胚胎学] R687.4[医药卫生—基础医学] R814.41