Westrich G H, Haas S B, Insall J N, Frachie A
Hospital for Special Surgery, New York, NY 10021, USA.
J Arthroplasty. 1995 Feb;10(1):47-51. doi: 10.1016/s0883-5403(05)80100-7.
Although it is known that there is some asymmetry of the tibial plateau, most total knee arthroplasty designs currently have a symmetric tibial component. Using resection specimen analysis of the tibial plateau from 100 total knee arthroplasty specimens, the authors have examined the tibial plateau to further delineate, quantitatively, the medial and lateral tibial configuration. Unmagnified radiographs of each of the specimens were produced. A line was drawn along the mediolateral axis. The midpoint and points 10, 20, and 30% from the medial and lateral peripheries were then calculated. The average anteroposterior medial 10, 20, and 30% dimensions were 3.79, 4.74, and 5.06 cm, respectively. The average anteroposterior lateral 10, 20, and 30% dimensions were 3.48, 4.10, and 4.16 cm, respectively. The ratios of the lateral/medial anteroposterior distances at 10, 20, and 30% from the periphery were 92.10, 86.77, and 82.46%, respectively. A total knee arthroplasty system that recognizes the difference in the medial and lateral tibial plateaus and designs a prosthesis to account for the smaller, lateral tibial plateau may achieve the goal of maximizing tibial coverage as well as eliminate the problems associated with a symmetric design.
尽管已知胫骨平台存在一定程度的不对称,但目前大多数全膝关节置换术的设计采用的是对称的胫骨部件。作者通过对100个全膝关节置换术标本的胫骨平台进行切除标本分析,进一步对胫骨平台进行定量研究,以明确其内侧和外侧的形态结构。对每个标本拍摄了未放大的X线片。沿内外侧轴画一条线。然后计算出中点以及距内侧和外侧边缘10%、20%和30%处的点。内侧10%、20%和30%处的平均前后径分别为3.79厘米、4.74厘米和5.06厘米。外侧10%、20%和30%处的平均前后径分别为3.48厘米、4.10厘米和4.16厘米。距边缘10%、20%和30%处的外侧/内侧前后距离之比分别为92.10%、86.77%和82.46%。一种能够认识到胫骨平台内外侧差异并设计出假体以适应较小外侧胫骨平台的全膝关节置换系统,可能实现最大化胫骨覆盖面积的目标,并消除与对称设计相关的问题。