【摘要】：背景:目前對膝關(guān)節(jié)半月板損傷的研究越來越多,但大多數(shù)研究都集中在半月板損傷的診斷及治療方面,對半月板損傷的發(fā)生原因及損傷發(fā)生機制影響因素的研究較少,之前有文章研究了脛骨后傾和半月板后傾角度的關(guān)系,但還未有研究報道過脛骨后傾和半月板長度的關(guān)系。本課題從脛骨后傾和半月板的關(guān)系著手,對正常國人脛骨后傾角度和半月板長度進行了測量,并進行相關(guān)性分析,從而對今后進一步了解半月板損傷的危險因素,對膝關(guān)節(jié)假體模擬半月板功能的脛骨平臺側(cè)設(shè)計及半月板異體移植時半月板形態(tài)的選擇提供指導(dǎo)。方法:本研究對25名男性和25名女性健康志愿者行右膝關(guān)節(jié)MRI掃描(平均年齡25.6±1.2歲),這些患者均否認既往膝關(guān)節(jié)疾病史及目前膝關(guān)節(jié)行走疼痛。掃描時志愿者體位為仰臥膝關(guān)節(jié)伸直0度中立位,掃描方向為軸位上垂直于股骨髁的穿髁線,矢狀位平行于脛骨機械軸。在矢狀位圖像中測量內(nèi)外側(cè)脛骨平臺的后傾角度,然后測量內(nèi)外側(cè)半月板前角及后角的厚度、水平長度和曲面長度。統(tǒng)計分析內(nèi)外側(cè)脛骨平臺后傾角和內(nèi)外側(cè)半月板前后角厚度、水平及曲面長度的相關(guān)性。結(jié)果:內(nèi)側(cè)脛骨平臺后傾角(n=50)平均值為7.86±2.73°,外側(cè)脛骨平臺后傾角(n=50)的平均值為7.47±3.14°。內(nèi)側(cè)半月板前角水平長度的平均值為13.61±2.05mm,內(nèi)側(cè)半月板后角水平長度平均值為22.18±2.44mm,內(nèi)側(cè)半月板前角厚度平均值為7.91±1.17mm,內(nèi)側(cè)半月板后角厚度平均值為8.73±1.43mm,內(nèi)側(cè)半月板前角曲面長度的平均值為15.51±1.12mm,內(nèi)側(cè)半月板后角曲面長度的平均值為22.36±0.47mm。外側(cè)半月板前角水平長度平均值為15.86±2.06mm,外側(cè)半月板后角水平長度平均值為17.43±3.84mm,外側(cè)半月板前角厚度平均值為7.20±1.22mm,外側(cè)半月板后角厚度的平均值為8.50±1.46mm,外側(cè)半月板前角曲面長度的平均值為22.71±5.27mm,外側(cè)半月板后角曲面長度平均值為17.90±0.37mm。內(nèi)側(cè)脛骨平臺后傾角與內(nèi)側(cè)半月板后角水平長度明顯相關(guān)(r=-0.409,P=0.025);但與內(nèi)側(cè)半月板前角厚度、水平及曲面長度、內(nèi)側(cè)半月板后角厚度和曲面長度不相關(guān)(P0.05);外側(cè)脛骨平臺后傾角與外側(cè)半月板前后角的厚度、水平及曲面長度不相關(guān)(P0.05)。結(jié)論:隨著內(nèi)側(cè)脛骨平臺后傾角增大,內(nèi)側(cè)半月板后角水平長度隨之減小。外側(cè)脛骨平臺后傾角與外側(cè)半月板的各長度值不相關(guān)。此研究對于進一步了解半月板損傷的危險因素、膝關(guān)節(jié)假體模擬半月板功能的脛骨平臺側(cè)設(shè)計及半月板異體移植時半月板形態(tài)的選擇都有重要的意義。
[Abstract]:Background: there are more and more researches on meniscus injury of knee joint at present, but most of the researches focus on the diagnosis and treatment of meniscus injury, and there are few researches on the cause and mechanism of meniscus injury. The relationship between tibial retroversion and meniscus backward angle has been studied before, but the relationship between tibia retroversion and meniscus length has not been reported. Based on the relationship between tibia retroversion and meniscus, the tibia angle and meniscus length of normal Chinese were measured, and the correlation analysis was carried out to further understand the risk factors of meniscus injury in the future. It provides guidance for the design of tibial plateau side of knee joint prosthesis simulating meniscus function and the choice of meniscus shape in meniscus allograft. Methods: in this study, right knee MRI scans were performed in 25 male and 25 female healthy volunteers (mean age 25.6 鹵1.2 years). During the scanning, the volunteers were placed in the neutral position of 0 degree extension of the supine knee joint, the scanning direction was the axial position perpendicular to the femoral condyle, and the sagittal position was parallel to the mechanical axis of the tibia. The tilting angle of the tibial plateau was measured in sagittal images, and the thickness, horizontal length and curved surface length of the anterior and posterior angles of the medial and lateral meniscus were measured. The correlation between the posterior inclination angle of the tibial plateau and the thickness of the anterior and posterior angle of the lateral meniscus, the level and the length of the curved surface were analyzed statistically. Results: the average posterior inclination angle of medial tibial plateau was 7.86 鹵2.73 擄, and that of lateral tibial plateau was 7.47 鹵3.14 擄. The average horizontal length of the anterior horn of the medial meniscus is 13.61 鹵2.05mm, the average horizontal length of the posterior horn of the medial meniscus is 22.18 鹵2.44mm, the average thickness of the anterior horn of the medial meniscus is 7.91 鹵1.17mm, the average thickness of the posterior horn of the medial meniscus is 8.73 鹵1.43mm, and the average surface of the anterior angle of the medial meniscus is 8.73 鹵1.43mm. The average length was 15.51 鹵1.12mm and the average length of the posterior angle of medial meniscus was 22.36 鹵0.47mm. The average horizontal length of the anterior horn of the lateral meniscus was 15.86 鹵2.06mm, the average horizontal length of the posterior horn of the lateral meniscus was 17.43 鹵3.84mm, the average thickness of the anterior horn of the lateral meniscus was 7.20 鹵1.22mm, the average of the thickness of the posterior horn of the lateral meniscus was 8.50 鹵1.46mm, the average of the lateral meniscus was 8.50 鹵1.46mm. The average length of the lateral meniscus is 22.71 鹵5.27mm, and the average length of the lateral meniscus is 17.90 鹵0.37mm. The posterior inclination of the medial tibial plateau was significantly correlated with the horizontal length of the posterior angle of the medial meniscus (r = -0.409), but with the thickness of the anterior angle of the medial meniscus, the level and the length of the surface. The thickness of posterior angle of medial meniscus was not related to the length of surface (P0.05), and the posterior inclination angle of lateral tibial plateau was not correlated with the thickness, level and length of surface of lateral meniscus (P0.05). Conclusion: the horizontal length of the posterior angle of the medial meniscus decreases with the increase of the posterior inclination of the medial tibial plateau. The posterior inclination of lateral tibial plateau was not correlated with the length of lateral meniscus. This study is of great significance for further understanding the risk factors of meniscus injury, the design of tibial plateau for knee prosthesis to simulate meniscus function and the choice of meniscus shape in meniscus allograft.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

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