非关节炎亚洲膝关节的人体测量学：是否到了需要种族特异性膝关节假体的时候？
Anthropometry of Nonarthritic Asian Knees: Is It Time for a Race-Specific Knee Implant?
机构信息
Department of Orthopaedics, Sir HN Reliance Foundation Hospital and Research Center, Mumbai, India.
Department of Applied Mathematics, Harvard University, Cambridge, MA, USA.
出版信息
Clin Orthop Surg. 2020 Jun;12(2):158-165. doi: 10.4055/cios19069. Epub 2020 May 14.
BACKGROUND
This study was done to study the anthropometry of nonarthritic Asian knees; to determine the differences in morphology between knees of different ethnicities and to compare the knee anthropometry values with sizes of available knee implants.
METHODS
Magnetic resonance imaging scans of 100 nonarthritic Indian knees were analyzed. Anteroposterior (AP) length, mediolateral (ML) length, and aspect ratio of the distal femur and proximal tibia, patellar length, and patellar tendon length were measured. These values were compared with values of other ethnicities from literature. The values were also compared with sizes of available knee implants and evaluated for mismatch.
RESULTS
All the parameters of female knees were significantly smaller than those of male knees ( < 0.05). The distal femur of Indian knees resembled that of Chinese knees with similar AP and ML lengths and aspect ratio. The distal femur of Indian knees had a significantly smaller AP, ML, and aspect ratio than those of Hispanic knees did. In comparison to Caucasian distal femur, Indian knees had smaller AP and ML lengths and larger aspect ratio. In terms of the proximal tibia, the Indian knees were smaller than Chinese (only ML), Caucasian (AP and ML) and Hispanic (AP and ML) knees. On comparison with implant sizes, there was a mismatch between the distal femur morphology and the dimensions of all implants. For a given AP length, the ML dimensions of all implants were smaller than the measured ML length of the knee. However, the tibial components of all the studied implants correlated well with the tibial morphology.
CONCLUSIONS
Distinct anthropometric differences exist between knees of different ethnicities. The knees of females were smaller than the knees of males. In Indian knees, the ML-AP aspect ratio of the distal femur was higher than that of the currently available femoral components. These results suggest the need for race-specific knee implants.
背景
本研究旨在研究非关节炎亚洲膝关节的人体测量学；确定不同种族膝关节形态的差异，并将膝关节人体测量值与现有膝关节假体的尺寸进行比较。
方法
对 100 例非关节炎印度膝关节的磁共振成像扫描进行了分析。测量了股骨远端的前后（AP）长度、内外（ML）长度和横截面积比，胫骨近端的髌骨长度和髌腱长度。将这些值与文献中其他种族的数值进行了比较。还将这些值与现有膝关节假体的尺寸进行了比较，并评估了不匹配的情况。
结果
所有女性膝关节的参数均显著小于男性膝关节（<0.05）。印度膝关节的股骨远端与中国膝关节相似，具有相似的 AP 和 ML 长度和横截面积比。与西班牙裔膝关节相比，印度膝关节的股骨远端 AP、ML 和横截面积比明显更小。与白种人股骨远端相比，印度膝关节的 AP 和 ML 长度较小，横截面积比较大。在胫骨近端方面，印度膝关节比中国（仅 ML）、白种人（AP 和 ML）和西班牙裔（AP 和 ML）膝关节小。与假体尺寸相比，股骨远端形态与所有假体的尺寸不匹配。对于给定的 AP 长度，所有假体的 ML 尺寸均小于膝关节测量的 ML 长度。然而，所有研究的胫骨假体与胫骨形态相关性良好。
结论
不同种族的膝关节存在明显的人体测量学差异。女性膝关节比男性膝关节小。在印度膝关节中，股骨远端的 ML-AP 横截面积比大于目前可用的股骨假体。这些结果表明需要针对特定种族的膝关节假体。
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