Zhang Yunjie, Wang Xiaofeng, Wu Zongming, Xia Qing, Shao Yunchao
Department of Orthopedic, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Orthopedic, Tongren Hospital, Shanghai Jiao Tong University, Shanghai, China.
J Knee Surg. 2017 Nov;30(9):936-942. doi: 10.1055/s-0037-1599250. Epub 2017 Mar 14.
We aimed to retrospectively investigate the morphology of the resected surfaces of femurs in Chinese patients who underwent total knee arthroplasty (TKA) and to assess the suitability of contemporary femoral components. Measurements on three-dimensional reconstruction after virtual bone cutting were performed on 142 knees from Chinese TKA candidates. The anteroposterior (AP) and mediolateral (ML) dimensions, aspect ratio (ML/AP), and posterior condylar angle (PCA) were measured in the axial plane; the height and length of medial and lateral anterior condyles and the maximal width of the anterior condyles were measured in the frontal plane. Femurs were matched to the prosthesis with the closest AP size. The ML dimensions of femurs were compared with the ML dimensions of the prosthesis. The AP and ML dimensions were significantly larger in male knees ( < 0.01), whereas the difference of aspect ratios was not found to be significantly different between genders ( = 0.26). Both medial and lateral heights of the anterior condyles were significantly higher in men after normalization by AP ( < 0.01 and < 0.05, respectively). The mean PCA averaged 3.8 degrees for Chinese subjects. The overall prevalence of clinically significant overhang was 6.4% in males and 4.8% in females. The design of femoral prosthesis with alternative ML dimensions of the femoral component is a solution to sufficiently avoid overhang while retaining ideal coverage when dealing with a high variation. Chinese men had higher anterior condyles than women after normalization by AP dimension. The mean PCA was 3.8 degrees for all patients with high variability.
我们旨在回顾性研究接受全膝关节置换术（TKA）的中国患者股骨切除表面的形态，并评估当代股骨假体的适用性。对142例中国TKA候选患者的膝关节进行虚拟截骨后的三维重建测量。在轴平面测量前后（AP）和内外侧（ML）尺寸、纵横比（ML/AP）以及后髁角（PCA）；在额平面测量内侧和外侧前髁的高度和长度以及前髁的最大宽度。将股骨与AP尺寸最接近的假体进行匹配。比较股骨的ML尺寸与假体的ML尺寸。男性膝关节的AP和ML尺寸显著更大（<0.01），而纵横比在性别之间未发现显著差异（=0.26）。经AP标准化后，男性的内侧和外侧前髁高度均显著更高（分别为<0.01和<0.05）。中国受试者的平均PCA为3.8度。临床上显著悬垂的总体患病率在男性中为6.4%，在女性中为4.8%。当处理高度变异时，设计具有不同ML尺寸的股骨假体是一种在保留理想覆盖的同时充分避免悬垂的解决方案。经AP尺寸标准化后，中国男性的前髁高于女性。所有高变异性患者的平均PCA为3.8度。
