Reddy A V Gurava, Sankineani Sukesh Rao, Agrawal Rahul, Thayi Chiranjeevi
Primary and Revision Arthroplasty Unit, Department of Orthopaedics and Traumatology Sunshine Hospital, Penderghast Road, Secunderabad, Telangana, 500003, India.
J Clin Orthop Trauma. 2020 Mar;11(Suppl 2):S228-S233. doi: 10.1016/j.jcot.2019.04.015. Epub 2019 Apr 26.
Background: Appropriate component sizing plays an important role in determining the functional outcome following total knee arthroplasty. Comparative studies of different populations have shown significant differences in the anthropometric parameters of knees in different race groups which negates the possibility of using a single sized implant system across different ethnic groups. This study evaluates the dimensions of femoral and tibial articular surfaces of Indian patients and compares the parameters with other ethnic groups and correlates the dimensions with five different commercially available knee systems.Material & Methods: Computerized tomography (CT) scans of contralateral normal knees of patients who underwent the scan for various ailments of the knee were retrieved retrospectively from the hospital database and 3D reconstruction of the images was done. Mediolateral dimensions (fML,tML), Anteroposterior dimensions (fAP, tAP) and aspect ratio (fML/fAP, tML/tAP) of the femur and tibia respectively were calculated and compared with the dimensions of different ethnic groups as well as the femoral and tibial components of five different knee prosthesis systems.
The average fML in the study group was less than that of Caucasian knees but was marginally larger than other ethnic groups. The fAP, tML and tAP was found to be smaller than all other ethnic groups but a larger femoral aspect ratio was reported than other ethnic groups. Among the implant systems, only NexGen LPS and Scorpio NRG implant femoral components closely matched the femoral dimensions in the study group whereas all implant systems showed significant mismatch with tibial component dimensions when compared to the study populations.
This study concludes that the dimensions of Indian knees are different from other ethnic groups and the use of commercially available knee Implants designed based on measurements in Caucasian populations can lead to significant mismatch between implant and resected bone surfaces.
背景：合适的部件尺寸在全膝关节置换术后功能结果的判定中起着重要作用。不同人群的比较研究表明，不同种族组膝关节的人体测量参数存在显著差异，这排除了在不同种族群体中使用单一尺寸植入系统的可能性。本研究评估了印度患者股骨和胫骨关节面的尺寸，并将这些参数与其他种族群体进行比较，同时将尺寸与五种不同的市售膝关节系统相关联。材料与方法：从医院数据库中回顾性检索因各种膝关节疾病接受扫描的患者对侧正常膝关节的计算机断层扫描（CT）图像，并对图像进行三维重建。分别计算股骨和胫骨的内外侧尺寸（fML、tML）、前后尺寸（fAP、tAP）和长宽比（fML/fAP、tML/tAP），并与不同种族群体的尺寸以及五种不同膝关节假体系统的股骨和胫骨部件尺寸进行比较。
研究组的平均fML小于白种人膝关节，但略大于其他种族群体。发现fAP、tML和tAP小于所有其他种族群体，但报告的股骨长宽比大于其他种族群体。在植入系统中，只有NexGen LPS和Scorpio NRG植入物的股骨部件与研究组的股骨尺寸紧密匹配，而与研究人群相比，所有植入系统的胫骨部件尺寸均存在明显不匹配。
本研究得出结论，印度人膝关节的尺寸与其他种族群体不同，使用基于白种人测量设计的市售膝关节植入物可能导致植入物与切除的骨表面之间存在明显不匹配。
