Pontoh Ludwig Andre, Dilogo Ismail Hadisoebroto, Rahyussalim Ahmad Jabbir, Widodo Wahyu, Pandapotan Hutapea Ricky Edwin, Fiolin Jessica
Department of Orthopaedic and Traumatology, Fatmawati General Hospital - Faculty of Medicine Universitas Indonesia, Jl. RS Fatmawati no. 4, Jakarta Selatan, 12430, Indonesia.
Department of Orthopaedic and Traumatology, Dr. Cipto Mangunkusumo General Hospital - Faculty of Medicine Universitas Indonesia, Jl. Diponegoro no. 71, Jakarta Pusat, 10430, Indonesia.
Ann Med Surg (Lond). 2021 Nov 19;72:103072. doi: 10.1016/j.amsu.2021.103072. eCollection 2021 Dec.
Restoration of patellar thickness is pivotal during a total knee arthroplasty (TKA). Several studies showed there are differences in the knee measurements between Asian and Western population.
This study aims to evaluate the patellar dimension and Bristol Index of patellar width to thickness (BIPWiT) using magnetic resonance imaging (MRI) in Asian population.
This is a descriptive epidemiology study.
101 MRI scans of young adult patients with normal patellofemoral joint (PFJ) age 17-40 were evaluated from January 2019 to December 2020. Exclusion criteria included patella-femoral pathology and degenerative joint disease. Data of gender, body height and weight were obtained from physical examination, while patella height, width and thickness were obtained using MRI measurement. Descriptive analysis was used to get the mean and standard deviation of patella dimension, whereas correlation between patella thickness with patella width and length were analyzed using Pearson correlation and BIPWiT ratio was obtained by dividing the patellar width and patellar thickness.
Mean patellar length was 30.06 ± 2.94 (29.48-30.64); patellar width was 44.13 ± 4.44 (43.26-45.01); and patellar thickness was 23.89 ± 2.33 (23.43-24.35). Patellar dimension in male were significantly larger compared to female (P < 0.001). However, there was no difference in cartilage thickness between male and female (P = 0.305). There was strong correlation between patellar width and patellar thickness (r = 0.66; P < 0.001) with BIPWiT ratio of 1.85 ± 0.15.
BIPWiT of 1.8:1 between patellar width and patellar thickness was recommended as a guide for patellar thickness restoration during TKA. There is no difference of patellar dimension between Asian and Western population in a healthy knee.
The result of BIPWiT ratio found in this study may aid upon pre-operative planning prior TKA for surgeons in order to achieve optimal patellar thickness and avoid patellofemoral problem.
Currently there are raising concerns about the different sizes of knee measurements between Asian and Western population which will affect techniques during TKA to achieve optimum result.
This study not only prove that there is no difference between patellar dimension of Asian and Caucasian but also found a similar BIPWiT ratio for patellar resection during TKA with previous literature.
Level III.
在全膝关节置换术（TKA）中，恢复髌骨厚度至关重要。多项研究表明，亚洲人和西方人在膝关节测量数据上存在差异。
本研究旨在利用磁共振成像（MRI）评估亚洲人群的髌骨尺寸及髌骨宽度与厚度比（BIPWiT）。
这是一项描述性流行病学研究。
对2019年1月至2020年12月间101例年龄在17 - 40岁、髌股关节（PFJ）正常的年轻成年患者的MRI扫描图像进行评估。排除标准包括髌股病变和退行性关节疾病。性别、身高和体重数据通过体格检查获取，而髌骨高度、宽度和厚度则通过MRI测量获得。采用描述性分析得出髌骨尺寸的均值和标准差，使用Pearson相关性分析髌骨厚度与宽度及长度之间的相关性，并通过髌骨宽度除以髌骨厚度得出BIPWiT比值。
髌骨平均长度为30.06 ± 2.94（29.48 - 30.64）；髌骨宽度为44.13 ± 4.44（43.26 - 45.01）；髌骨厚度为23.89 ± 2.33（23.43 - 24.35）。男性的髌骨尺寸显著大于女性（P < 0.001）。然而，男性和女性的软骨厚度无差异（P = 0.305）。髌骨宽度与厚度之间存在强相关性（r = 0.66；P < 0.001），BIPWiT比值为1.85 ± 0.15。
建议将髌骨宽度与厚度之比为1.8:1作为TKA期间恢复髌骨厚度的指导标准。健康膝关节的亚洲人和西方人在髌骨尺寸上无差异。
本研究中发现的BIPWiT比值结果可能有助于外科医生在TKA术前规划时实现最佳髌骨厚度，避免髌股问题。
目前，人们越来越关注亚洲人和西方人膝关节测量尺寸的差异，这会影响TKA手术技术以达到最佳效果。
本研究不仅证明了亚洲人和白种人在髌骨尺寸上无差异，还发现TKA期间髌骨切除的BIPWiT比值与先前文献相似。
三级。
