华南人胫骨平台后倾角的三维测量及临床意义

中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (4): 411-413.

华南人胫骨平台后倾角的三维测量及临床意义

李军¹，　荆珏华¹，　史占军²，　詹俊锋¹

1.安徽医科大学第二附属医院骨科，合肥 230601； 2．南方医科大学南方医院关节与骨病外科，广州 510515

收稿日期:2012-12-02 出版日期:2013-07-25 发布日期:2013-07-24
通讯作者: 荆珏华，主任医师，硕士生导师， E-mail：jjhhu@sina.com E-mail:junliarmy@163.com
作者简介:李军（1987-），男，医师，博士，研究方向：关节功能重建和脊髓损伤修复，Tel：(0551)63869505

Three dimensional measurement and clinical significance of posterior slope angle of the tibial plateau in south Chinese

LI Jun¹, JING Jue-hua¹, SHI Zhan-jun², ZHAN Jun-feng¹

1.Department of Orthopaedics, the Second Hospital, Anhui Medical University, Hefei 230601, China；2. Department of Joint, Nanfang Hospital, Southern Medical University, Guangzhou,510515, China

Received:2012-12-02 Online:2013-07-25 Published:2013-07-24

摘要/Abstract

摘要：

目的　测量华南成人正常胫骨平台后倾角数据，为改进及设计适合中国人（尤其华南人）的膝关节假体和在全膝关节置换术中行合理的胫骨截骨，提供参考和依据。方法　对80例华南志愿者膝关节行薄层螺旋CT扫描后，用Mimics软件重建出三维模型，导入Unigraphics NX软件中测量其胫骨内外侧平台的后倾角。结果　胫骨内侧平台后倾角，左侧（8.47±3.42）°，右侧（7.84±3.30）° ；男性（7.69±　2.89）°，女性（8.62±3.74）°；平均（8.16±3.37）°；胫骨外侧平台后倾角，左侧（6.89±3.42）°，右侧（6.82±2.78）°；男性（6.84±2.82）°，女性（6.87±3.01）°；平均（6.85±2.90）°。胫骨内、外侧平台后倾角在不同性别、侧别间无显著性差异（P＞0.05），但胫骨内侧平台后倾角明显大于胫骨外侧平台后倾角（P＜0.05）。结论　华南成人正常胫骨平台后倾角的个体差异较大，均值小于国内其他地区报道和国外大多数同类研究。

关键词: 胫骨平台, 后倾角, 三维测量, 人工膝关节置换术

Abstract:

Objective　To provide references and evidences for design of the knee prosthesis suitable for south Chinese and optimal tibial osteotomy in total knee arthroplasty, posterior slope angle of the tibial plateau in adult south Chinese were measured.　Methods　80 adult volunteers were enrolled in this experiment. Their knees were scanned by spiral CT with obtained data imported into MIMICS for three-dimensional reconstruction; then both of posterior slope angle of the lateral tibial plateau and the medial tibial plateau were measured by Unigraphics NX software.　Results　The posterior slope angle of the medial tibial plateau in adult south Chinese was (6.86±1.92)° for the left, and (6.45±2.02)° for the right, (6.20±2.03)° for the male and (7.19±1.78)° for the female, with an average of (8.16±3.37)°; and posterior slope angle of the lateral tibial plateau was (6.89±3.42)° for the left, (6.82±2.78)° for the right, （6.84±2.82）° for the male and （6.87±3.01）° for the female, with an average of （6.85±2.90）°. There were no statistically significant differences between different genders and sides for posterior slope angle of the lateral tibial plateau or the medial tibial plateau（P>0.05）; However, the posterior slope angle of the medial tibial plateau was significantly greater than the lateral tibial plateau(P<0.05).　Conclusions　The posterior slope angle in adult south Chinese has a greater individual difference than the average in other area at home and abroad.

Key words: Tibial plateau, Posterior slope angle, Three dimensional measurement, Total knee arthroplasty

中图分类号:

R318.17

李军, 荆珏华, 史占军, 詹俊锋. 华南人胫骨平台后倾角的三维测量及临床意义[J]. 中国临床解剖学杂志, 2013, 31(4): 411-413.

LI Jun, JING Jue-Hua, SHI Tie-Jun, DAN Dun-Feng. Three dimensional measurement and clinical significance of posterior slope angle of the tibial plateau in south Chinese[J]. Chinese Journal Of Clinical Anatomy, 2013, 31(4): 411-413.

参考文献

[1] 罗吉伟，黄美贤，金大地，等.华南地区成人胫骨平台内侧与腓骨头高度差距及其临床意义
[J]. 中国临床解剖学杂志,2006, 24(4): 381-384.

[2] Pugh JW, Radin EL, Rose RM. Quantitative studies of human subchondral cancellous bone. Its relationship to the state of its overlying cartilage
[J]. J Bone Joint Surg Am, 1974, 56(2):313-321.

[3] Goldstein SA, Wilson DL, Sonstegard DA, et al. The mechanical properties of human tibial trabecular bone as a function of metaphyseal location
[J]. J Biomech, 1983,16(12):965-969.

[4] Matsuda S, Miura H, Nagamine R, et al. Posterior tibial slope in the normal and varus knee
[J]. Am J Knee Surg, 1999, 12(3):165-168.

[5] Jiang CC, Yip KM, Liu TK. Posterior slope angle of the medial tibial plateau
[J]. J Formos Med Assoc, 1994, 93(6):509-512.

[6] Migaud H, De Ladoucette A, Dohin B, et al. Influence of the tibial slope on tibial translation and mobility of non-constrained total knee prosthesis
[J]. Rev Chir Orthop Reparatrice Appar Mot, 1996, 82(1):7-13.

[7] Singerman R, Dean JC, Pagan HD, et al. Decreased posterior tibial slope increases strain in the posterior cruciate ligament following total knee arthroplasty
[J]. J Arthroplasty, 1996, 11(1):99-103.

[8] De Boer JJ, Blankevoort L, Kingma I, et al. In vitro study of inter-individual variation in posterior slope in the knee joint
[J]. Clin Biomech (Bristol, Avon), 2009, 24(6):488-492.

[9] Kuwano T, Urabe K, Miura H, et al. Importance of the lateral anatomic tibial slope as a guide to the tibial cut in total knee arthroplasty in Japanese patients
[J]. J Orthop Sci, 2005, 10(1):42-47.

[10] Yoo JH, Chang CB, Shin KS, et al. Anatomical references to assess the posterior tibial slope in total knee arthroplasty: a comparison of 5 anatomical axes
[J]. J Arthroplasty, 2008, 23(4):586-592.

[11]曲铁兵, 曾纪洲, 林源,等. 华北地区成人正常胫骨内侧平台后倾角的测量及临床意义
[J]. 中华骨科杂志, 2003,23(8):455-458.

[12] 黄文华, 姜楠, 钟世镇,等. 胫骨平台后倾角的测量及临床意义
[J]. 中国骨与关节损伤杂志, 2007,22(10):825-828.

[13]Bai B, Baez J, Testa N, et al. Effect of posterior cut angle on tibial component loading
[J]. J Arthroplasty, 2000, 15(7):916-920.

[14]Hofmann AA, Bachus KN, Wyatt RW. Effect of the tibial cut on subsidence following total knee arthroplasty
[J]. Clin Orthop Relat Res, 1991, (269):63-69.