Budhiparama Nicolaas C, Lumban-Gaol Imelda, Ifran Nadia Nastassia, de Groot Pieter C J, Utomo Dwikora Novembri, Nelissen Rob G H H
Nicolaas Institute of Constructive Orthopaedic Research and Education Foundation for Arthroplasty and Sports Medicine, Medistra Hospital, Jl. Jend. Gatot Subroto Kav. 59, Jakarta, 12950, Indonesia.
Department of Orthopaedics and Traumatology, School of Medicine, University of Airlangga, Jl. Mayjend. Prof. Dr. Moestopo 6-8, Surabaya, 60286, Indonesia.
Knee Surg Sports Traumatol Arthrosc. 2021 Feb;29(2):358-369. doi: 10.1007/s00167-020-05914-9. Epub 2020 Mar 11.
The aim of this study was to evaluate the anthropometric differences between knees of Indonesian Asians and Dutch Caucasians and the fit of nine different knee implant systems.
A total of 268 anteroposterior (AP) and lateral knee preoperative radiographs from 134 consecutive patients scheduled for total knee arthroplasty at two different centres in Jakarta and Leiden were included. Both patient groups were matched according to age and sex and included 67 Asians and 67 Caucasians. We assessed the radiographic differences between the Asian and Caucasian anthropometric data. The dimensions of the nine knee implant designs (Vanguard, Genesis II, Persona Standard, Persona Narrow, GK Sphere, Gemini, Attune Standard, Attune Narrow, and Sigma PFC) were compared with the patients' anthropometric (distal femur and proximal tibia) measurements.
The Dutch Caucasian patients had larger mediolateral (ML) and AP femoral and tibial dimensions than the Indonesian Asians. The aspect ratios of the distal femur and tibia were larger in Asians than in Caucasians. The AP and ML dimensions were mismatched between the tibial components of the nine knee systems and the Asian anthropometric data. Both groups had larger ML distal femoral dimensions than the knee systems.
Absolute and relative differences in knee dimensions exist not only between Asian and Caucasian knees but also within both groups. Not all TKA systems had a good fit with the Asian and Caucasian knee phenotypes. An increase in the range of available knee component sizes would be beneficial, although TKA remains an adequate compromise.
III.
本研究旨在评估印度尼西亚亚洲人和荷兰白种人膝关节的人体测量学差异，以及九种不同膝关节植入系统的适配情况。
纳入了来自雅加达和莱顿两个不同中心的134例计划进行全膝关节置换术的连续患者的268张前后位（AP）和侧位膝关节术前X线片。两组患者根据年龄和性别进行匹配，包括67名亚洲人和67名白种人。我们评估了亚洲人和白种人人体测量数据之间的影像学差异。将九种膝关节植入设计（Vanguard、Genesis II、Persona Standard、Persona Narrow、GK Sphere、Gemini、Attune Standard、Attune Narrow和Sigma PFC）的尺寸与患者的人体测量学（股骨远端和胫骨近端）测量值进行比较。
荷兰白种人患者的内外侧（ML）以及前后位股骨和胫骨尺寸比印度尼西亚亚洲人大。亚洲人股骨远端和胫骨的纵横比比白种人大。九种膝关节系统的胫骨组件与亚洲人体测量数据之间的前后位和内外侧尺寸不匹配。两组患者的股骨远端内外侧尺寸均大于膝关节系统。
亚洲人和白种人膝关节不仅在绝对尺寸上存在差异，在相对尺寸上也存在差异，而且两组内部也存在差异。并非所有全膝关节置换系统都能很好地适配亚洲人和白种人的膝关节表型。增加可用膝关节组件尺寸的范围将是有益的，尽管全膝关节置换术仍然是一种适当的折衷方案。
III级。
