MRI-Based Characterization of Bone Anatomy in the Human Knee for Size Matching of a Medial Meniscal Implant
MRI-Based Characterization of Bone Anatomy in the Human Knee for Size Matching of a Medial Meniscal Implant
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DOI：
10.1115/1.4002490
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发表时间：
2010-10-01
影响因子：
1.7
通讯作者：
Linder-Ganz, Eran
中科院分区：
文献类型：
--
作者：
Elsner, Jonathan J.;Portnoy, Sigal;Linder-Ganz, Eran
同种异体半月板或合成半月板已被提议作为半月板切除术后恢复接触压力的一种手段。然而，当天然半月板严重受损/缺失时，无法根据受体尺寸确定所需尺寸，需要从对侧膝关节或受伤膝关节骨骼的磁共振成像（MRI）来估算。由于经济和实际原因，使用对侧膝关节进行尺寸匹配存在问题。因此，仅基于候选膝关节几何形状的尺寸算法具有显著优势。本研究的目的是描述膝关节尺寸的中值和变异性，并利用最少的基于成像的骨骼测量值来建立一组表示膝关节尺寸的数学关系。对118例MRI扫描进行了胫骨、股骨和半月板测量，并用于建立一个具有代表性的参数化膝关节模型，其中所有尺寸都用胫骨平台宽度来表示。通过皮尔逊相关性以及布兰德 - 奥特曼（1986年，“评估两种临床测量方法一致性的统计方法”，《柳叶刀》，1期，第307 - 310页）图，将预测值与另外20名受试者的直接MRI测量值进行比较，从而对该模型进行了验证。男性膝关节的解剖学参数与相应的女性测量值相比明显更大（约17%）。然而，胫骨、股骨和半月板测量值之间的大多数关系（56个中有43个）在男性和女性人群之间没有显著差异（p≥0.05），这表明男性和女性关节之间的差异通常与比例有关，而非形状。膝关节模型预测的尺寸与直接从MRI测量的尺寸高度吻合（R²>0.96），布兰德 - 奥特曼图显示约95%的数据点都很好地落在一致性的±2标准偏差线内。本研究中提出的模型的优势在于能够描述给定胫骨宽度的典型膝关节比例，并可用于基于单次测量来预测候选膝关节的尺寸。研究中呈现的解剖学/人体测量学数据可用于人工半月板植入物的尺寸算法或人工半月板假体的设计。[DOI: 10.1115/1.4002490]
Allograft or synthetic menisci have been suggested as a means to restore contact pressures following meniscectomy. However, when the natural meniscus is severely damaged/absent, the necessary size cannot be determined according to the recipient size and there is a need to estimate it from magnetic resonance imaging (MRI) of the contralateral knee or the injured knee bones. The use of the contralateral-knee for size matching is problematic due to economic and practical reasons. Hence, there are significant advantages for a sizing algorithm based only on the candidate knee geometry. The aim of this study is to characterize midrange values and variability of knee dimensions and to develop a set of mathematical relations representing knee dimensions using a minimum of imaging-based bone measurements. Tibia, femur, and meniscus measurements were taken in 118 MRI scans and used to develop a representative parametric knee model in which all dimensions are expressed using tibia plateau width. The model was verified by comparing the predicted values to direct MRI measurements for 20 additional subjects by means of the Pearson correlation and Bland and Altman (1986, "Statistical Methods for Assessing Agreement Between Two Methods of Clinical Measurement," Lancet, 1, pp. 307-310) plot. Anatomical parameters in the male knee were significantly larger (similar to 17%) compared with corresponding female measurements. However, most relations between tibia, femur, and meniscus measurements (43/56) were not significantly different between male and female populations (p >= 0.05), indicating that differences between male and female joints are generally related to scaling and not shape. Dimensions predicted by the knee model were in a good agreement with dimensions measured directly from the MRI (R-2>0.96) and the Bland and Altman plot indicated that similar to 95% of data points were well within the +/- 2 standard deviation lines of agreement. The model proposed in this study is advantageous in being able to describe typical knee proportions for a given tibial width and can be used to predict the dimensions of a candidate knee based on a single measurement. The anatomical/anthropometric data presented in the study can be utilized in a sizing algorithm for artificial meniscal implants or in the design of artificial meniscus prostheses. [DOI: 10.1115/1.4002490]