基于三维CT的大骨节病全膝置换术截骨面解剖参数测量

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中图分类号：R684 文献标志码：ADOI：10.7652/jdyxb202504014

ABSTRACT： ObjectiveTo measure and analyze anatomic parameters of resected distal femurs and proximal tibias in Kaschin-Beck disease（KBD）and osteoarthritic（OA）knees which fit for total knee arthroplasty（TKA），so as to provide basis for designing suitable knee prosthesis for KBD patients.MethodsA total of 154 knees （75 KBD and 79 OA）fitting for TKA underwent thre-dimensional reconstruction；resection of distal femursand proximal tibias was simulated during TKA. We measured the distal femoral mediolateral （fML），lateral anteroposterior （fLAP），medial anteroposterior（fMAP），medial condylar width（fMCW），lateral condylar width（fLCW）and fML/fLAP aspect ratio，proximaltibial mediolateral（tML），middle anteroposterior（tAP），medial anteroposterior （tMAP），lateral anteroposterior（tLAP） dimension，and tML/tAP aspect ratio to compare the morphometric differences between KBD and OA knees.ResultsThe measured anatomic parameters of resected distal femurs and proximal tibias in both male and female patients of KBD group were smaller than those of OA knees （ P<0.01⟩ .We also found that KBD group had larger distal femur fML/fLAPand proximal tibia tML/tAP aspect ratios than those of OA knees （ P<0.01⟩ . This indicated that under a given AP dimension，KBD knees need an oval-shaped prosthesis with a wider ML length and more spherical-shaped prosthesis with relatively narrow ML dimensions in OA knees.

ConclusionThe anatomy of distal femurs and proximal tibias shows significant differences in size and shape between KBD and OA knees，which provides theoretical basis for designing proper knee prosthesis for KBD patients.

KEY WORDS： Kashin-Beck disease （KBD）； total knee arthroplasty；distal femur;proximal tibia； three-dimensional reconstruction

大骨节病（Kashin-Beckdisease，KBD）是一种患病率和致残率很高的地方性骨关节病，其病变主要侵犯12岁以下儿童骨发育阶段四肢软骨、板软骨和关节软骨，导致软骨原发性变性、发育障碍、坏死以及继发性骨关节病1。（剩余10235字）