不同旋转对线的牛津单髁胫骨假体与中国南方汉族人群胫骨形态的匹配度分析

doi:10.13418/j.issn.1001-165x.2026.5.04

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中国临床解剖学杂志 ›› 2026, Vol. 44 ›› Issue (5) : 519-526. DOI: 10.13418/j.issn.1001-165x.2026.5.04

应用解剖

不同旋转对线的牛津单髁胫骨假体与中国南方汉族人群胫骨形态的匹配度分析

周俊皓¹，胡意辉^1,2，林国太³，冯柏淋¹，林可伟¹，罗家宝¹，张梓维¹，钟环¹，欧阳汉斌¹*

作者信息 +

Morphological matching analysis of tibial prosthesis in Oxford unicompartmental arthroplasty based on different rotational alignments in the Southern Han Chinese population

Zhou Junhao¹, Hu Yihui^1,2, Lin Guotai³, Feng Bolin¹, Lin Kewei¹, Luo Jiabao¹, Zhang Ziwei¹, Zhong Huan¹, Ouyang Hanbin¹*

Author information +

文章历史 +

摘要

目的评估不同旋转对线截骨参考对中国南方汉族人群牛津单髁置换术胫骨假体匹配度的影响。方法回顾性纳入40例（80膝）中国南方汉族成人双下肢CT影像数据并分别构建下肢三维模型。对80膝进行数字化模拟牛津单髁关节置换，分别以sAP线、FAMA线以及MIR线为参照进行胫骨矢状面与水平面截骨；获得截骨后的胫骨三维模型，测量其水平截骨面的形态学参数，由1名高年资关节外科医师选择适宜的胫骨假体模拟植入并进行匹配性分析，最后对测量数据进行统计分析。结果 ICC分析表明，2名医师对20个模型的独立测量结果具有高度一致性（ICC=0.984，P<0.05）；sAP组的水平截骨面纵横比最接近牛津单髁胫骨假体的设计比例；对应地，sAP截骨组的假体匹配率最高（88.8%），其次为FAMA组（82.5%），MIR组最低（25.0%），组间差异有统计学意义（P<0.05）。sAP组与FAMA组的匹配率无显著差异（P>0.05），但两组均显著高于MIR组（P<0.05）。而同在满足匹配的条件下，sAP组与FAMA组在假体覆盖率及各区域的非匹配面积上无显著差异，而sAP组假体在内侧区的非匹配面积要显著低于MIR组（P<0.05）。结论在南方汉族患者人群中，相较于MIR线，基于sAP线或FAMA线进行胫骨矢状截骨均可获得更优的牛津单髁胫骨假体匹配效果。新一代的假体应充分参考国人的胫骨形态学特征，进一步对假体的前后径和后内侧曲率参数进行优化。

Abstract

Objective To evaluate the impact of different rotational alignment references for tibial osteotomy on the matching of the tibial component in Oxford unicompartmental knee arthroplasty (UKA) among the Southern Chinese Han population. Methods A retrospective analysis was conducted on computed tomography (CT) imaging data of both lower limbs from 40 cases of Southern Chinese Han adults (80 knees). Three-dimensional (3D) models of the lower limbs were reconstructed. Digital simulations of Oxford UKA were performed on all 80 knees. Tibial osteotomies in the sagittal and axial planes were performed using the sAP line, FAMA line, and the MIR line as references, respectively. 3D models of the resected tibiae were obtained, and morphological parameters of the axial resection plane were measured. A senior joint surgeon selected the appropriate tibial component for simulated implantation and conducted matching analysis. Statistical analysis was then performed on the measurement data. Results ICC analysis indicated excellent consistency between the independent measurements of two surgeons for 20 models (ICC= 0.984, P<0.05). The sAP group demonstrated an aspect ratio closest to the design ratio of the Oxford UKA tibial component. Correspondingly, the prosthesis matching rate was the highest in the sAP osteotomy group (88.8%), followed by the FAMA group (82.5%), and lowest in the MIR group (25.0%), with statistically significant differences among the groups (P<0.05). There was no significant difference in the matching rate between the sAP group and the FAMA group (P>0.05). However, both groups showed significantly higher matching rates compared with the MIR group (P<0.05). Under matching conditions, there was no significant differences between the sAP and FAMA groups in terms of prosthesis coverage or mismatch area across zones. However, the mismatch area in the medial zone for the sAP group was significantly smaller than that of the MIR group (P<0.05). Conclusions Among Southern Chinese Han patients, compared with the MIR line, using either the sAP line or the FAMA line for tibial sagittal osteotomy yields superior matching outcomes for the Oxford unicompartmental tibial prosthesis. The design of next-generation prostheses should be tailored to the tibial morphometry of the Chinese population, with particular attention to refining the parametric design of the anteroposterior dimension and posteromedial curvature.

导出引用

周俊皓, 胡意辉, 林国太, 冯柏淋, 林可伟, 罗家宝, 张梓维, 钟环, 欧阳汉斌. 不同旋转对线的牛津单髁胫骨假体与中国南方汉族人群胫骨形态的匹配度分析[J]. 中国临床解剖学杂志. 2026, 44(5): 519-526 https://doi.org/10.13418/j.issn.1001-165x.2026.5.04

Zhou Junhao, Hu Yihui, Lin Guotai, Feng Bolin, Lin Kewei, Luo Jiabao, Zhang Ziwei, Zhong Huan, Ouyang Hanbin. Morphological matching analysis of tibial prosthesis in Oxford unicompartmental arthroplasty based on different rotational alignments in the Southern Han Chinese population[J]. Chinese Journal of Clinical Anatomy. 2026, 44(5): 519-526 https://doi.org/10.13418/j.issn.1001-165x.2026.5.04

中图分类号： R322.72

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