Iranpour Farhad, Merican Azhar M, Amis Andrew A, Cobb Justin P
Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Imperial College London, 7th Floor, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK.
Clin Orthop Relat Res. 2008 May;466(5):1198-203. doi: 10.1007/s11999-008-0130-x. Epub 2008 Mar 11.
Establishing the appropriate size of the patellar implant-bone composite is one of the important steps ensuring functional success in arthroplasty. Conventionally, the patella is measured intraoperatively and its thickness is used to guide the depth of resection. However, in a diseased joint, this may not reflect the native patellar thickness. We studied the relationship between the patellar thickness and various patellar dimensions on three-dimensional reconstructed computed tomographic scans from 37 normal adult knees. Patellar width correlated with thickness. The average patellar width:thickness ratio was 2.0 (standard deviation, 0.106; 95% confidence interval, 1.96-2.03). The cartilage thickness was on average 2.5 mm (standard deviation, 1.0). The width:thickness ratio was similar in 79 digital radiographs taken before TKA of knees without patellofemoral disease (mean, 2.1; standard deviation, 0.28). When compared with the two other methods for calculating patellar resection described in the literature, the width:thickness ratio was more reliable. The width:thickness ratio appears anatomically constant and may be a useful guide for estimating premorbid patellar thickness.
确定合适大小的髌骨植入物-骨复合体是确保关节置换术功能成功的重要步骤之一。传统上，术中测量髌骨并利用其厚度来指导截骨深度。然而，在病变关节中，这可能无法反映髌骨的原始厚度。我们在37例正常成人膝关节的三维重建计算机断层扫描上研究了髌骨厚度与各种髌骨尺寸之间的关系。髌骨宽度与厚度相关。髌骨平均宽度与厚度之比为2.0（标准差为0.106；95%置信区间为1.96 - 2.03）。软骨平均厚度为2.5毫米（标准差为1.0）。在无髌股疾病的膝关节全膝关节置换术前拍摄的79张数字X线片中，宽度与厚度之比相似（平均值为2.1；标准差为0.28）。与文献中描述的另外两种计算髌骨截骨的方法相比，宽度与厚度之比更可靠。宽度与厚度之比在解剖学上似乎是恒定的，可能是估计病前髌骨厚度的有用指标。
