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基于三维重建计算机断层扫描技术测量中国东北人群胫骨近端形态

Measurement of proximal tibial morphology in northeast Chinese population based on three-dimensional reconstruction computer tomography.

作者信息

Zhang Kesong, Han Qing, Wang Hecheng, Yang Kerong, Chen Bingpeng, Zhang Yong, Zhang Shiruo, Wang Jincheng, Chu Haichen

机构信息

Department of Orthopedics, the Second Hospital of Jilin University.

Emergency department, Hospital of Stomatology of Jilin University.

出版信息

Medicine (Baltimore). 2019 Nov;98(45):e17508. doi: 10.1097/MD.0000000000017508.

Abstract

Tibial component of total knee arthroplasty (TKA) is designed according to morphology of proximal tibia to a large extent. Owing to racial difference, current design of tibial component based on Caucasian may not be suitable for Chinese patients. Meanwhile, data of proximal tibial morphology in Chinese population is lacking. The objective of this research was to investigate proximal tibial morphology of northeast Chinese population.Computer tomography (CT) image of 164 northeast Chinese participants was collected. After three-dimensional (3D) reconstruction, size of tibia plateau and TKA resected surface were gauged to guide the design of TKA tibia prothesis in northeast Chinese population. Measurement of tibial size mainly includes tibial mediolateral length (tML), tibial medial/lateral anteroposterior length (tMAP and tLAP). Afterwards, tML/tAP ratio of tibia plateau and TKA resected surface were calculated as feature point of tibia prothesis. tMAP/tLAP ratio of TKA resected surface was calculated to represent tibial asymmetry degree. Medial and lateral posterior tibial slope (MPTS and LPTS) were also measured to give reference to posterior angle of tibia prothesis and angle of tibia osteotomy in TKA. Independent sample t test was performed to conduct statistical analysis, P < .05 was regarded as statistically significance.Northeast Chinese male has larger knee size than female. Significant difference of tML/tAP ratio was also observed between male and female on tibia plateau (1.71 ± 0.07 vs 1.77 ± 0.09) but not on TKA resected surface (1.60 ± 0.05 versus 1.61 ± 0.06). Significant difference of tMAP/tLAP ratio between male and female was also found and they were 1.31 ± 1.03 and 1.11 ± 0.05 respectively. Northeast Chinese female has higher PTS than male (MPTS: 9.56 ± 2.96° vs 8.81 ± 2.87° and LPTS: 8.57 ± 3.19° vs 8.44 ± 2.76°).Significant gender-difference of tibial size and asymmetry degree of tibial resected surface were found between northeast Chinese male and female. Meanwhile, northeast Chinese population has smaller knee size, larger PTS and tML/tAP ratio than that of Caucasian population. Therefore, Chinese-specific and gender-specific tibial prostheses were strongly recommended to be designed.

摘要

全膝关节置换术(TKA)的胫骨组件在很大程度上是根据胫骨近端的形态设计的。由于种族差异,目前基于白种人的胫骨组件设计可能不适用于中国患者。同时,中国人群胫骨近端形态的数据也很缺乏。本研究的目的是调查中国东北人群的胫骨近端形态。

收集了164名中国东北参与者的计算机断层扫描(CT)图像。经过三维(3D)重建后,测量胫骨平台和TKA截骨面的尺寸,以指导中国东北人群TKA胫骨假体的设计。胫骨尺寸的测量主要包括胫骨内外侧长度(tML)、胫骨内侧/外侧前后长度(tMAP和tLAP)。之后,计算胫骨平台和TKA截骨面的tML/tAP比值作为胫骨假体的特征点。计算TKA截骨面的tMAP/tLAP比值以代表胫骨不对称程度。还测量了胫骨内侧和外侧后倾角度(MPTS和LPTS),为TKA中胫骨假体的后倾角和胫骨截骨角度提供参考。采用独立样本t检验进行统计分析,P<0.05被认为具有统计学意义。

中国东北男性的膝关节尺寸大于女性。胫骨平台上男性和女性的tML/tAP比值也存在显著差异(1.71±0.07对1.77±0.09),但在TKA截骨面上没有差异(1.60±0.05对1.61±0.06)。男性和女性的tMAP/tLAP比值也存在显著差异,分别为1.31±1.03和1.11±0.05。中国东北女性的PTS高于男性(MPTS:9.56±2.96°对8.81±2.87°,LPTS:8.57±3.19°对8.44±2.76°)。

在中国东北男性和女性之间发现了胫骨尺寸和胫骨截骨面不对称程度的显著性别差异。同时,中国东北人群的膝关节尺寸比白种人小,PTS和tML/tAP比值比白种人大。因此,强烈建议设计针对中国人群和性别的胫骨假体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afd6/6855598/7e211508262a/medi-98-e17508-g001.jpg

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