中国福建东南部成人女性胫骨近端表面及断面几何参数三维数字化测量及临床意义

摘要

背景：人工膝关节置换是治疗膝关节严重形变最主要的方法，但由于现有膝关节假体型号有限，且中国福建东南部人群身材较北方人群矮小，因此临床易出现假体型号不适合，置换效果不良的现象。　　目的：测量中国福建东南部成人女性胫骨近端表面及断面几何参数，为该地区女性人工膝关节设计及置换提供基础数据。　　方法：选取中国福建东南部85例干燥的女性骨骼标本，测量胫骨平台宽，胫骨内侧平台宽、前后径，胫骨外侧平台宽、前后径，并选取临床正常胫骨近端CT资料36例(38-65岁)，扫描范围为30 cm(髁间隆起最高点以下30 cm)，层厚为0.625 mm，利用Mimics 16.0软件三维重建和测量以上指标并将重建模型以层厚为3 mm连续分割，共10层，将左右最宽处平均分为4等份，测量3个等分点上胫骨平台前后径，并用统计软件分析其中线形数据之间关系。　　结果与结论：成功获得了中国福建东南部成人女性胫骨标本几何参数，胫骨平台内外侧前后径大于内外侧宽，内外侧前后径与内外侧宽数值相当，胫骨10个断层平面，内外侧前后径总是小于中间前后径，有3组数值先升高再降低。胫骨全长与胫骨内侧平台宽度及前后径、胫骨外侧平台宽度及前后径之间，胫骨内侧平台宽度与前后径之间，胫骨外侧平台宽度与前后径之间均呈正相关关系(P<0.05)。结果说明，福建东南部成人女性胫骨平台相关参数的呈一定规律性变化，文章结果可能为该地区人工胫骨平台设计及手术提供量化参考数据。%BACKGROUND:Artificial knee joint replacement is the main surgical method for the treatment of severe knee joint deformation, but due to the limited existing knee prosthesis type. The stature of Fujian population in southeast China was shorter than that of the north. The size of artificial knee joint usual y did not fit for patients in clinic. The substitution effect was poor. OBJECTIVE:To measure the geometric parameters of proximal surface and cross-section of adult female tibia in southeastern area of Fujian Province of China, and provide basic data for design and replacement of artificial knee joint in females. METHODS:We chose 85 cases of dry female skeleton in southeastern area of Fujian Province of China, measured tibial plateau width, medial tibial plateau width and anteroposterior diameter, lateral tibial plateau width and anteroposterior diameter. We col ected clinical normal proximal tibial CT data of 36 patients (38-65 years old), with scan range of 30 cm (intercondylar eminence 30 cm) and layer thickness of 0.625 mm. Mimics 16.0 three-dimensional reconstruction software was used to measure above indexes and cut the reconstructed models with thickness of 3 mm, total y 10 layers. We divided its widest distance into four equal parts, and measured tibial anteroposterior diameter on three points. Statistical software was used to analyze the linear relationship between the data. RESULTS AND CONCLUSION:The experiment has successful y obtained geometric parameters of tibial specimens of adult females in southeastern area of Fujian province of China. Tibia platform inside and outside diameters were greater than the width inside and outside;inside and outside diameter and inside and outside width were similar. Ten segment planes of tibia, inside and outside diameters were always less than middle anteroposterior diameter. Three groups of data increased firstly, and then reduced. There were positive correlations between tibia length and width of the medial tibia platform, the lateral tibia platform width and anteroposterior diameter, the medial tibia platform width and anteroposterior diameter, and the lateral tibia platform width and anteroposterior diameter (P<0.05). These results suggested that relevant parameters of tibial plateau adult women in southeastern area of Fujian province of China showed some regular changes. Our results may provide quantitative reference data for the design and operation of artificial tibial plateau.