国人正常胫骨近端线性参数测量及特性分析
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Measurement and characteristic analysis of proximal tibia linear parameters in normal Chinese
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    摘要:

    目的获取国人正常胫骨近端不同截面各线性参数正常参考值,为国产人工膝关节假体设计以及全膝关节置换术临床操作提供参考依据。方法选取61例(100膝,男65膝,女35膝)国人正常膝关节,年龄1781岁,平均47.2岁;分别按照性别、年龄和侧别进行分组;利用原始CT扫描图像资料重建膝关节,并在工作平台上对胫骨进行旋转、切割,测量不同截面的相关线性参数。结果测得截面前后径为(48.9±3.1)mm,横径为(75.2±4.5)mm,前后径与横径的比值为0.650±0.034;经过横轴距离内外侧平台边缘10%、20%、30%点的前后距离平均值分别为36.1、46.6、51.2、37.1、44.1和47.6mm;分析得出胫骨截面前后径、横径与前后径的比值在不同截骨高度和不同性别中的差异均有统计学意义。结论国人胫骨近端的几何形态与解剖特点同西方人有明显的区别;应用西方人设计的胫骨平台假体要考虑到国人的特点和性别差异;设计国人膝关节假体以及进行全膝关节置换手术时应该注意到性别的差异。

    Abstract:

    Objective To obtain the normal linear parameters on the different resection levels of normal proximal tibia in Chinese, and provide reference for improving the design of domestic knee prosthesis and clinic technology of TKA. Method Choose 61 normal Chinese (100 knees, include 65 male and 35 female knees), with average age of 47.2 years (range from 1 7 to 81 year-old), Then divided them into groups according to the age, side of the knee and gender. Utilized original CT image data to set up the three-dimensional model of Chinese normal knees and measure the related linear parameters of different proximal tibia sections on the work station. Result The average anterior-posterior (AP) and medial-lateral (ML) lengths of the proximal tibia section were 48.9±3.1 and 75.2±4.5mm, respectively; the ratio of anterior- posterior (AP) and medial-lateral (ML) was 0.650±0.034. the average anterior-posterior dimensions through the spots with 10, 20 and 30% were 36.1, 46.6, 51.2, 37.1, 44.1 and 47.6 mm, respectively; It is confirmed through statistics analysis that the length of AP and the ratio of AP/ML shows statistics significance among different gender and resection level. Conclusion The geometry and anatomy of proximal tibia in Chinese shows significant differences comparing with westerner; the characteristics and the gender difference should be considered when we use the tibial plateau prosthesis designed by the westerner; the sex difference should also be taken into account when we design the domestic tibial plateau prosthesis and total knee arthroplasty.

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张博,潘江,林源,曲铁兵.国人正常胫骨近端线性参数测量及特性分析[J].医用生物力学,2007,22(4):351-355

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