Ma Qian-Li, Lipman Joseph D, Cheng Cheng-Kung, Wang Xiao-Nan, Zhang Yi-Yuan, You Bin
Department of Biomechanics, Hospital for Special Surgery, New York, New York; Department of Orthopaedic Surgery, The Second Municipal Hospital of Fuzhou affiliated with Xiamen University, Fuzhou, Fujian, China.
Department of Biomechanics, Hospital for Special Surgery, New York, New York.
J Arthroplasty. 2017 Sep;32(9):2878-2886. doi: 10.1016/j.arth.2017.03.069. Epub 2017 Apr 7.
The bone morphologies of intact knees were measured and compared between Chinese and Caucasian populations. However, to assess if distinct designs of implants are necessary for the Chinese population owing to different morphologies and sizes, the knee measurements after osteotomy performed in total knee arthroplasty were evaluated.
Thirty-seven Caucasian and 50 Chinese patients' knees were examined using computed tomography scans. Mimics were applied to reconstruct 3-dimensional bone models. Dimensions of the 3-dimensional knee models and simulated bone resections during total knee arthroplasty were measured using Geomagic Studio and Pro/ENGINEER. The morphologic measurements of the native and resected femur and tibia included the anteroposterior (AP) depth, mediolateral (ML) width, notch width, knee physical valgus angle, tibial slope angle, and the ML-to-AP ratio of the femur, tibia, and resected femur. Statistical analysis was performed using the independent samples t test and the Pearson correlation coefficient in SPSS for Windows. Values of P < .05 were considered significant.
No measurements were significantly different between the Chinese and Caucasian knees. However, the Chinese female showed significant differences compared with the Chinese male on distal femoral measurements both presimulated and postsimulated osteotomy such as a smaller mean ML-to-AP ratio in presimulated (1.3 ± 0.1) and postsimulated (1.3 ± 0.1) osteotomy.
The necessity of designing a full set of total knee components specifically for the Chinese population is still undetermined. However, we suggest designing femoral components specific for the Chinese females because of different postosteotomy distal femoral ML-to-AP ratio between the Chinese males and the Chinese females.
对中国人群和白种人群完整膝关节的骨骼形态进行了测量和比较。然而，为了评估由于形态和尺寸不同，中国人群是否需要不同设计的植入物，对全膝关节置换术中截骨后的膝关节测量进行了评估。
使用计算机断层扫描对37名白种人和50名中国患者的膝关节进行检查。应用Mimics软件重建三维骨骼模型。使用Geomagic Studio和Pro/ENGINEER测量三维膝关节模型的尺寸以及全膝关节置换术中模拟的骨切除量。对天然和截骨后的股骨和胫骨的形态学测量包括前后（AP）深度、内外侧（ML）宽度、髁间窝宽度、膝关节生理外翻角、胫骨坡度角以及股骨、胫骨和截骨后股骨的ML与AP比值。使用Windows版SPSS中的独立样本t检验和Pearson相关系数进行统计分析。P <.05的值被认为具有统计学意义。
中国人群和白种人群的膝关节测量值均无显著差异。然而，中国女性在模拟截骨术前和术后的股骨远端测量值与中国男性相比存在显著差异，例如模拟截骨术前（1.3±0.1）和术后（1.3±0.1）的平均ML与AP比值较小。
专门为中国人群设计一整套全膝关节组件的必要性仍未确定。然而，由于中国男性和女性截骨术后股骨远端ML与AP比值不同，我们建议为中国女性设计特定的股骨组件。
