Effects of anatomical deviation of the human tibial plateau on knee prosthesis design based on human evolutionary rhythm differences
Zhang Bo1, Qu Shenghe2, Zhao Zhixin3
1Department of Orthopedic, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; 2Camford Royal School, Beijing 100000, China; 3Beijing Delcone Orthopaedic Hospital, Beijing 100143, China
Abstract:Objective This work aimed to explore the differences in human evolutionary rhythm, analyze the matching rate of imported knee prosthesis and the tibial plateau osteotomy surface of Chinese adults, and determine the influence of the tibial plateau on the design of knee prostheses. Methods In this study, 60 patients (120 knees) with non-knee diseases and 20 healthy volunteers (40 knees) were selected from the Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University from January 2018 to January 2020. The patients included 46 males (92 knees) and 34 females (68 knees). The patients were 24-72 years old, with an average age of 46.8 years. Bilateral knee CT scan and 3D reconstruction were performed, and 3D reconstructed tibial images were rotated and cut on GE ADW 4.3 Advanced Image Workstation. Linear parameters such as transverse diameter and anteroposterior diameter of tibial plateau osteotomy surface were measured and calculated, and the differences in parameters between men and women were compared. Statistical analysis was performed. The matching rates of three imported knee prostheses designed based on Caucasian physique parameters (Depuy PFC Sigma [prosthesis A], Link-Gemini MK-II [prosthesis B], and Zimmer Nexgen [prosthesis C]) and the tibial plateau osteotomy surface of Chinese adults were evaluated using the 5 mm tolerance range method. Pairwise comparison was performed by χ2 test. Results The mean cross diameter of the tibial plateau was (74.2±2.8) mm in 80 Chinese adults with 160 knees; that of males was (76.2±2.7) mm, which was higher than that of females (68.1 mm±2.9 mm), and the difference was significant (t=18.18, P <0.001). The mean diameter was (48.2±2.6) mm; that of males was (50.5±2.5) mm, which was higher than that of females (46.3 mm±2.7 mm), with statistical significance (t=10.15, P <0.001). The matching rates of prostheses A, B, and C with the tibial plateau osteotomy surface of Chinese adults were 41.25% (66/160), 46.88% (75/160), and 26.25% (42/160), respectively. The matching rates of prosthesis C were lower than those of prostheses A and B, and the differences were statistically significant (χ2=8.05, 14.67, all P values <0.05). No significant difference was found between prostheses A and B (χ2=1.03, P=0.184). Conclusion A significant difference is noted between Chinese adults and Caucasians in the normal bearing surface of the tibial plateau. The matching degree between imported knee prosthesis and the tibial plateau osteotomy surface of Chinese adults is generally low. The tibial plateau section of Chinese adults is relatively round, which suggests that in the course of human evolution, Chinese walked from four limbs to upright maybe earlier than Caucasians.
张博, 曲声赫, 赵志昕. 基于人类进化节奏差异造成的人种胫骨平台解剖偏差对膝关节假体设计的影响[J]. 中华解剖与临床杂志, 2022, 27(9): 626-632.
Zhang Bo, Qu Shenghe, Zhao Zhixin. Effects of anatomical deviation of the human tibial plateau on knee prosthesis design based on human evolutionary rhythm differences. Chinese Journal of Anatomy and Clinics, 2022, 27(9): 626-632.
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