Abstract：Objective To explore the differences of CT image-related anatomical measurements of normal patellofemoral joints between genders in Northwest China, and to provide reference for design of knee prosthesis.Methods CT data of normal knee joints of 78 volunteers (156 sides) recruited in the Second Affiliated Hospital of Xi'an Jiaotong University from May 2017 to August 2017 were collected for cross-sectional study. Using GE revolution CT machine, 78 volunteers were scanned from spina iliace to pelma. After three-dimensional reconstruction, patella thickness, patella facet thickness, patella width, patella lateral facet width, longitudinal length of the whole patella, longitudinal length of the articulating surface of the patella, the mediolateral and anteroposterior sizes of the femur, anterior femoral offset, and sulcus angle were measured respectively. Two-sample t-test for independent samples was used to analyze the differences among different genders. Linear regression model was used to control the bias of age, height and weight, and then the gender differences of measurement parameters were analyzed again. Pearson correlation analysis was performed for all parameters.Results There were significant differences in age, height, weight and BMI between different genders in 78 volunteers (t=6.270, 17.602, 11.366, 4.377, all P values＜0.01). Before controlling age, height and weight bias, patella thickness, patella facet thickness, patella width, patella lateral facet width, longitudinal length of the whole patella, longitudinal length of the articulating surface of the patella, the mediolateral and anteroposterior sizes of the femur, and anterior femoral offset in male group were (22.39±1.53)mm,(11.75±0.94)mm,(47.04±2.81)mm,(27.18±2.16)mm,(45.18±2.74)mm,(30.60±2.28)mm,(86.31±3.94)mm,(66.76±3.26)mm,(6.37±1.38)mm, respectively, which were significantly larger than those of females, (19.75±1.29)mm,(10.91±0.95)mm,(40.47±2.30)mm,(23.37±1.61)mm,(38.74±2.51)mm,(26.76±1.70)mm,(74.28±3.00)mm,(60.07±2.89)mm,(5.63±1.36)mm, respectively, and the differences were statistically significant (t=11.692, 5.582, 16.024, 12.518, 15.303, 11.969, 21.545, 13.581, 3.381, P＜0.01). After control bias, there was no significant difference in patella facet thickness and anterior femoral offset between males and females (all P values＞0.05). The differences of other parameters between males and females were still statistically significant (t=2.057, 6.581, 5.207, 4.673, 3.045, 8.053, 2.331, all P values＜0.05). The sulcus angle was 139.43°±4.78° for males and 138.29°±4.22° for females. Regardless of age, height, and weight bias, the difference was not statistically significant (all P values＞0.05). Pearson correlation results showed that there was a negative correlation between the sulcus angle and the age, the patella facet thickness, and the anterior femoral offset. There was a positive correlation between other observations. In the positive correlation indexes, the correlation coefficient between the anterior femoral offset and other indicators was less than 0.3, showing a weak correlation; the correlation coefficient between the sulcus angle and the patella lateral facet width was 0.32, and the correlation coefficient between the sulcus angle and other indicators was less than 0.3, showing a weak correlation.Conclusions CT-related anatomical measurements of normal patellofemoral joints were different between different genders. Anterior femoral offset and sulcus angle might have large variability, even in the same size of femur or patella. Therefore, when designing a prosthesis, it is necessary not only to meet the needs of patients according to gender, but also to pay attention to the diversity of the design of the anterior femoral condyle.
李哲, 田润, 李越, 孔宁, 李沂阳, 刘晓辉, 王坤正, 杨佩. 西北地区国人正常髌股关节CT影像解剖学研究[J]. 中华解剖与临床杂志, 2019, 24(1): 39-46.
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2019, Vol. 24 
