目的 通过比较双侧膝关节的形态学参数，评估利用镜像法逆向重建膝关节假体的有效性。 方法 以健侧为模板提取参数，基于逆向工程思路重建膝关节假体。实验共收集双侧CT分析区域数据正常的胫骨18例、股骨69例，进行三维重建，利用Geomagic Control 2015进行配准，分别计算双侧膝关节的胫骨、股骨的偏差体积和面积及软件处理偏差，分析双侧膝关节的形态学差异，验证镜像法结合逆向工程技术设计个性化假体的可行性。 结果 偏差分析结果显示，超过85%区域差异小于1 mm，双侧膝关节存在高度的相似性。用Geomagic进行曲面优化前后股骨表面积无显著差异（P=0.197），胫骨表面积也无统计学差异（P=0.798）。股骨相似程度为（0.3427±0.9956）mm，胫骨的相似程度为（0.4165±1.0714）mm。 结论 双侧股骨远端及胫骨近端的关节面区域存在较高的相似性，可以利用健侧的股骨关节面原位逆向建模数据拟合的方法设计个性化假体。
Objective To evaluate the effectiveness of reverse reconstruction of knee prosthesis using image method, by comparing the morphological parameters of bilateral knee joints. Methods This experiment designed a personalized prostheses insteading of defect data by matching and analyzing the morphological similarity of the bilateral knee joint. The experiment harvested 18 cases of bilateral tibias and 69 cases of bilateral femurs. Carried out three-dimensional reconstruction, calculated the volume and area of the bilateral knee joints, and then evaluated the difference of the morphological data of the bilateral knee joints. Results The results of deviation analysis showed that more than 85% regional differences were less than 1mm, and bilateral knee joints were highly similar. Before the optimization with geomagic, there was no significant difference between the bilateral femurs (P=0.197) and the tibias (P=0.798) in area. And the deviation interval of femur was 0.3427±0.9956 mm and tibia was 0.4165±1.0714 mm. Conclusions The analysis shows that there is a high similarity in the area of the knee joint surface. Areas with large differences are mainly distributed at the metaphysis. The mirror model of intact distal femur surface can be used to design personalize prosthesis.
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