Giannicola Giuseppe, Spinello Paolo, Scacchi Marco, Gumina Stefano
Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, "Sapienza" University of Rome- Policlinico Umberto I, Rome, Italy.
Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, "Sapienza" University of Rome- Policlinico Umberto I, Rome, Italy.
J Shoulder Elbow Surg. 2017 May;26(5):e128-e136. doi: 10.1016/j.jse.2016.10.012. Epub 2017 Jan 25.
Little is known about the cartilage thickness of the distal humerus and how it affects the shape of the articular surface. Our aims were to assess cartilage thickness and to determine the extent to which it affects the true profile of the distal humerus.
We assessed 78 healthy elbows (39 subjects, 19 women and 20 men) with a mean age of 28 years (range, 21-32 years). Cartilage thickness was measured by use of high-definition magnetic resonance imaging scans at 19 different points of the articular surface, 13 on the trochlea and 6 on the capitellum, on the axial and coronal views. Bone diameters at the medial and lateral trochlear ridges, trochlear groove, and capitellum, as well as the articular surface width, were measured. Subject height was used as an indirect measurement of humerus length. Pearson correlation coefficients and the Student t test were used.
Cartilage thickness showed a significant variation (range, 0.4-1.8 mm) independent of sex and side. It appeared thinner at the medial and lateral edges, whereas it increased at the level of the trochleocapitellar and trochlear grooves, the lateral trochlear ridges, and the center of the capitellum. The mean bone diameters of the medial ridge, lateral ridge, trochlear groove, and capitellum measured 25.1 mm, 21 mm, 16.9 mm, and 19.6 mm, respectively. The mean width of the articular surface was 42.9 mm (range, 35.8-50.2 mm). No significant correlation was found between cartilage thickness and bone dimensions.
Cartilage thickness is not uniform and modifies the morphologic shape and diameters of the humeral articular surface. These findings may be relevant to anatomic prosthesis design.
关于肱骨远端软骨厚度及其如何影响关节面形状,人们了解甚少。我们的目的是评估软骨厚度,并确定其对肱骨远端真实轮廓的影响程度。
我们评估了78例健康肘部(39名受试者,19名女性和20名男性),平均年龄28岁(范围21 - 32岁)。通过使用高清磁共振成像扫描,在轴向和冠状面上,于关节面的19个不同点测量软骨厚度,其中13个点在滑车,6个点在肱骨小头。测量了滑车内侧和外侧嵴、滑车沟以及肱骨小头处的骨直径,以及关节面宽度。将受试者身高用作肱骨长度的间接测量指标。使用了Pearson相关系数和Student t检验。
软骨厚度显示出显著差异(范围0.4 - 1.8毫米),与性别和侧别无关。在内侧和外侧边缘处似乎较薄,而在滑车小头和滑车沟水平、滑车外侧嵴以及肱骨小头中心处则增厚。内侧嵴、外侧嵴、滑车沟和肱骨小头的平均骨直径分别为25.1毫米、21毫米、16.9毫米和19.6毫米。关节面的平均宽度为42.9毫米(范围35.8 - 50.2毫米)。未发现软骨厚度与骨尺寸之间存在显著相关性。
软骨厚度不均匀,会改变肱骨关节面的形态和直径。这些发现可能与解剖型假体设计相关。