中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (27): 4291-4296.doi: 10.12307/2023.396

• 数字化骨科 digital orthopedics • 上一篇    下一篇

中国北方60岁以上老年人股骨外翻角、股骨后髁角数字化测量及与中青年的比较

李佳伟 1，2，李灿然1，和雨洁1，邬  超1，金  凤3，张  凯4，李筱贺1   

  1. 1内蒙古医科大学人体解剖教研室，内蒙古自治区呼和浩特市   010010；2内蒙古科技大学包头医学院第二附属医院影像中心，内蒙古自治区包头市   014030；3内蒙古医科大学附属医院影像科，内蒙古自治区呼和浩特市   010010；4乌兰察布市第二人民医院骨科，内蒙古自治区乌兰察布市   012000
  • 收稿日期:2022-05-23 接受日期:2022-07-19 出版日期:2023-09-28 发布日期:2022-11-07
  • 通讯作者: 李筱贺，博士，博士生导师，内蒙古医科大学人体解剖教研室，内蒙古自治区呼和浩特市 010010 张凯，博士，乌兰察布市第二人民医院骨科，内蒙古自治区乌兰察布市 012000
  • 作者简介:李佳伟，男，1988年生，内蒙古自治区包头市人，汉族，在读硕士，主要从事骨与关节的研究。 李灿然，女，2002年生，内蒙古自治区呼和浩特市人，蒙古族，主要从事骨与关节的研究。
  • 基金资助:
    内蒙古自然科学基金项目(2020MS08124)，项目负责人：李筱贺；内蒙古医科大学重点项目(YKD2021ZD001)，项目负责人：李筱贺；乌兰察布市科技计划项目 (YKD202002007)，项目负责人：张凯

Digital measurement of femoral valgus angle and femoral posterior condyle angle in elderly people over 60 years old in northern China and comparison with young and middle-aged population

Li Jiawei1, 2, Li Canran1, He Yujie1, Wu Chao1, Jin Feng3, Zhang Kai4, Li Xiaohe1   

  1. 1Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 2Department of Imaging, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou 014030, Inner Mongolia Autonomous Region, China; 3Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 4Department of Orthopedics, The Second People’s Hospital of Ulanqab, Ulanqab 012000, Inner Mongolia Autonomous Region, China
  • Received:2022-05-23 Accepted:2022-07-19 Online:2023-09-28 Published:2022-11-07
  • Contact: Li Xiaohe, MD, Doctoral supervisor, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China Zhang Kai, MD, Department of Orthopedics, The Second People’s Hospital of Ulanqab, Ulanqab 012000, Inner Mongolia Autonomous Region, China
  • About author:Li Jiawei, Master candidate, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; Department of Imaging, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou 014030, Inner Mongolia Autonomous Region, China Li Canran, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China
  • Supported by:
    Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2020MS08124 (to LXH); Key Project of Inner Mongolia Medical University, No. YKD2021ZD001 (to LXH); Ulanqab Science and Technology Plan Project, No. YKD202002007 (to ZK)

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摘要：


文题释义：

股骨外翻角：为股骨机械轴与股骨远端解剖轴在冠状面上的夹角，影响全膝关节置换术中股骨侧假体的髓内定位，对术中股骨远端截骨方向及假体安装具有重要意义。
股骨后髁角：为股骨上髁轴与股骨后髁轴的夹角，对股骨远端假体旋转对线具有重要意义。

背景：全膝关节置换是终末期膝关节骨性关节炎的有效治疗手段，股骨外翻角及股骨后髁角是术前评估的重要参数，选择适宜的角度进行截骨有利于术后下肢力线的重建及假体的稳定，因此研究股骨外翻角及股骨后髁角对全膝关节置换术中截骨意义重大。
目的：测量内蒙古地区不同年龄段人群的股骨外翻角、股骨后髁角，了解不同年龄段人群两项参数的分布情况。
方法：选择2018年1月至2021年12月在内蒙古医科大学附属医院及乌兰察布市第二人民医院进行下肢血管检查患者，共纳入175例，分为4组：< 60岁(A组，n=41)、60-69岁(B组，n=52)、70-79岁(C组，n=41)、≥ 80岁(D组，n=41)。收集患者的下肢血管CT资料，使用Mimics 21.0软件进行三维重建并旋转至标准正位，模拟下肢X射线片测量股骨外翻角，在CT横断面测量股骨后髁角。利用SPSS 25.0软件分析同性别不同年龄段间两个参数的差异、同年龄段不同性别间两参数的差异以及两个参数与年龄的相关性。
结果与结论：①相同性别下，A、B组股骨外翻角小于C、D组(P < 0.05)；对于男性患者，A、B组股骨后髁角小于C、D组(P < 0.05)；对于女性患者，A组股骨后髁角小于C、D组(P < 0.05)，B组小于D组(P < 0.05)；②相同组别下，男女间股骨外翻角、股骨后髁角比较差异均无显著性意义(P > 0.05)；③Pearson相关分析显示，股骨外翻角、股骨后髁角与年龄存在正相关，相关系数分别为0.31，0.46 (P < 0.01)；④结果表明，老年人全膝关节置换术中截骨应考虑年龄对股骨外翻角及股骨后髁角的影响，建议术前行下肢CT检查及三维重建测量，明确股骨外翻角及股骨后髁角，进行个体化精准截骨。
https://orcid.org/0000-0002-9346-9312(李佳伟)；https://orcid.org/0000-0002-8165-0990(李灿然)
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 全膝关节置换术, 老年人, 股骨外翻角, 股骨后髁角, 三维数字化测量

Abstract: BACKGROUND: Total knee arthroplasty is an effective treatment for end-stage osteoarthritis of the knee. The femoral valgus angle and femoral posterior condyle angle are important parameters for preoperative evaluation, and selecting the proper angle for osteotomy will be beneficial to the reconstruction of the force line of the lower limb and the stability of the prosthesis after surgery. Therefore, the study of femoral valgus angle and femoral posterior condyle angle is of great significance for the precise osteotomy of total knee arthroplasty.  
OBJECTIVE: To measure the femoral valgus angle and femoral posterior condyle angle in different age groups of elderly people in Inner Mongolia Autonomous Region and to understand the distribution of these two parameters in different age groups.
METHODS: A total of 175 patients receiving lower extremity vascular examination from January 2018 to December 2021 in The Affiliated Hospital of Inner Mongolia Medical University and The Second People’s Hospital of Ulanqab were selected in this study. They were divided into four groups: < 60 years old (group A, n=41), 60-69 years old (group B, n=52), 70-79 years old (group C, n=41), and > 80 years old (group D, n=41). The CT data of the lower extremity blood vessels of the patients were collected. Mimics 21.0 software was used to reconstruct 3D model and rotate to standard orthostatic position. Simulated lower limb X-ray films were used to measure the femoral valgus angle. CT cross-section was used to measure the femoral posterior condyle angle. The SPSS 25.0 software was used to analyze the difference of two parameters among different age groups, and difference of two parameters between sexes in the same age group and the correlation between the two parameters and age.
RESULTS AND CONCLUSION: (1) For the same gender, the femoral valgus angle of groups A and B was smaller than that of groups C and D (P < 0.05). For male patients, the femoral posterior condyle angles in groups A and B were smaller than those in groups C and D (P < 0.05). For female patients, the femoral posterior condyle angle in group A was smaller than that in groups C and D (P < 0.05), and that in group B was smaller than that in group D (P < 0.05). (2) In the same group, there was no significant difference in femoral valgus angle and femoral posterior condyle angle between men and women (P > 0.05). (3) Pearson correlation analysis showed that femoral valgus angle and femoral posterior condyle angle were positively correlated with age, and the correlation coefficients were 0.31 and 0.46, respectively (P < 0.01). (4) The results confirm that when performing total knee arthroplasty for elderly people, the effect of age on femoral valgus angle and femoral posterior condyle angle should be considered. Preoperative CT examination of the lower extremity and 3D reconstruction measurement are recommended to clarify the femoral valgus angle and femoral posterior condyle angle for individualized osteotomy.

Key words: total knee arthroplasty, elderly, femoral valgus angle, femoral posterior condyle angle, three-dimensional digital measurement

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