中国人胫骨骨干相对于胫骨平台的偏移。
The offset of the tibial shaft from the tibial plateau in Chinese people.
机构信息
Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing 100035, China.
出版信息
J Bone Joint Surg Am. 2010 Aug 18;92(10):1981-7. doi: 10.2106/JBJS.I.00969.
BACKGROUND
Long-stem tibial components are available for complex primary and revision total knee arthroplasties. Most of the stems' designs are based on anatomic data from Western populations. We conducted a morphologic study to determine the relationship of the tibial shaft to the tibial plateau in Chinese people.
METHODS
We included knees from fifty Chinese individuals (twenty-five females and twenty-five males) in this study. On magnetic resonance imaging scans of the tibial plateau and the proximal part of the tibial shaft of each lower limb, the distance between the axis of the tibial shaft and the center of the tibial plateau was measured and was defined as the offset of the tibial shaft from the tibial plateau at three resection levels: the first just distal to the subchondral bone of the medial tibial plateau, the second 5 mm distal to it, and the third 10 mm distal to it. The dimensions of the tibial plateau were measured as well.
RESULTS
At the first, second, and third resection levels, the mean tibial shaft offsets (and standard deviations) from the center of the tibial plateau were, respectively, 7.23 + or - 2.44 mm (3.40 + or - 1.94 mm of mediolateral offset and 6.22 + or - 2.05 mm of anteroposterior offset), 6.33 + or - 2.26 mm (3.14 + or - 2.04 mm of mediolateral offset and 5.24 + or - 1.96 mm of anteroposterior offset), and 4.75 + or - 2.07 mm (2.68 + or - 1.91 mm of mediolateral offset and 3.46 + or - 2.03 mm of anteroposterior offset). At each resection level, the mean offset in the male group was significantly larger than that in the female group.
CONCLUSIONS
There is a large variation in the offset of the tibial shaft from the tibial plateau in Chinese people. The axis of the tibial shaft is located anterolateral to the center of the tibial plateau in this population.
CLINICAL RELEVANCE
The use of an anterolaterally offset tibial keel or stem seems more suitable for Chinese patients undergoing primary or revision total knee arthroplasty.
背景
长柄胫骨组件可用于复杂的初次和翻修全膝关节置换术。大多数柄的设计基于西方人群的解剖学数据。我们进行了一项形态学研究，以确定中国人胫骨骨干与胫骨平台的关系。
方法
我们纳入了 50 名中国人（25 名女性和 25 名男性）的膝关节。在每侧下肢胫骨平台和胫骨近端的磁共振成像扫描中，测量胫骨骨干轴线与胫骨平台中心之间的距离，并定义为胫骨骨干相对于胫骨平台在三个截骨平面的偏移：第一平面位于内侧胫骨平台的软骨下骨远端 5mm 处，第二平面位于其远端 5mm 处，第三平面位于其远端 10mm 处。还测量了胫骨平台的尺寸。
结果
在第一、第二和第三截骨平面，胫骨骨干相对于胫骨平台中心的平均偏移量（标准差）分别为 7.23±2.44mm（3.40±1.94mm 的内外侧偏移和 6.22±2.05mm 的前后偏移）、6.33±2.26mm（3.14±2.04mm 的内外侧偏移和 5.24±1.96mm 的前后偏移）和 4.75±2.07mm（2.68±1.91mm 的内外侧偏移和 3.46±2.03mm 的前后偏移）。在每个截骨平面，男性组的平均偏移量均显著大于女性组。
结论
中国人胫骨骨干相对于胫骨平台的偏移量存在较大差异。在该人群中，胫骨骨干的轴线位于胫骨平台的前外侧。
临床意义
对于接受初次或翻修全膝关节置换术的中国患者，使用前外侧偏移的胫骨翼或柄似乎更合适。
Zotero 插件