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术中胫骨形态学的人体测量学测量:与当前胫骨植入物尺寸的比较。

Intraoperative anthropometric measurements of tibial morphology: comparisons with the dimensions of current tibial implants.

机构信息

Institute of Sports Medicine, Peking University Third Hospital, No. 49, North Garden Road, Beijing, 100191, China.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):2924-30. doi: 10.1007/s00167-014-3258-0. Epub 2014 Sep 2.

Abstract

PURPOSES

This study analyzed morphological differences in the resected proximal tibial surfaces of Chinese males and females undergoing total knee arthroplasty (TKA) and compared the measurements with the dimensions of five currently used tibial implants.

METHODS

The mediolateral (ML), middle anteroposterior (AP), medial anteroposterior (MAP), and lateral anteroposterior (LAP) dimensions of the resected tibial surfaces of 976 Chinese TKA knees (177 male, 799 female) were measured. The ML/AP ratio of every knee was calculated. These morphological data were compared with the dimensions of five currently used tibial implants.

RESULTS

The ML, AP, MAP, and LAP dimensions of the resected proximal tibias showed significant differences according to gender. Compared with currently used tibial implants, the smaller implants showed tibial ML undersizing and the larger implants showed tibial ML overhang. The ML/AP aspect ratio progressively decreased with increasing AP dimension in the resected proximal tibias, which contrasts with the relatively constant or increased (NexGen) aspect ratio in currently used tibial implants. Males showed a higher ML/AP aspect ratio than females for a given AP dimension. This indicates that for an implant with a given AP dimension, the tibial ML dimension tends to be undersized in males and to overhang in females.

CONCLUSION

The results of this study may provide fundamental data for designing suitable tibial implants for use in the Chinese population, especially for design of gender-specific prostheses.

LEVEL OF EVIDENCE

II.

摘要

目的

本研究分析了行全膝关节置换术(TKA)的中国男性和女性患者的胫骨近端截骨面的形态差异,并将测量结果与 5 种目前使用的胫骨假体的尺寸进行比较。

方法

测量了 976 例中国 TKA 膝关节(男 177 例,女 799 例)胫骨截骨面的横径(ML)、中间前后径(AP)、内前后径(MAP)和外前后径(LAP)。计算了每例膝关节的 ML/AP 比值。将这些形态学数据与 5 种目前使用的胫骨假体的尺寸进行比较。

结果

根据性别,胫骨近端截骨面的 ML、AP、MAP 和 LAP 尺寸存在显著差异。与目前使用的胫骨假体相比,较小的假体显示胫骨 ML 尺寸不足,较大的假体显示胫骨 ML 突出。与目前使用的胫骨假体相比,胫骨近端截骨面的 ML/AP 纵横比随 AP 尺寸的增加而逐渐减小,而目前使用的胫骨假体的 ML/AP 纵横比相对恒定或增加(NexGen)。对于给定的 AP 尺寸,男性的 ML/AP 纵横比高于女性,这表明对于给定 AP 尺寸的假体,胫骨 ML 尺寸在男性中趋于不足,在女性中趋于突出。

结论

本研究的结果可为设计适合中国人群使用的胫骨假体提供基础数据,特别是为设计性别特异性假体提供基础数据。

证据水平

II 级。

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