슬관절 전치환술에서 3차원 단층촬영술을 이용한 슬개골의 가상 절제
Three Dimensional CT based Virtual Patellar Resection in Female Patients undergoing Total Knee Replacement
- 주제(키워드) patella , 3D CT , patellar resurfacing
- 발행기관 아주대학교
- 지도교수 원예연
- 발행년도 2012
- 학위수여년월 2012. 2
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000012226
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Background: Though rotational alignment and antero-posterior positioning of the femoral component influences patello-femoral mechanics, it is also significantly influenced by the accuracy of the patellar resection, with the resultant thickness and symmetry of the patella-implant composite Methods: We performed virtual patellar resection with digital software using 3D-CT scans of knees from 49 patients who underwent primary TKR at our hospital, comparing two commonly used resection methods, i.e., the tendon method (TM), and the subchondral method (SCM), to determine an ideal resection plane with respect to the symmetry and thickness of the patellar remnant. Results: The TM gave a thicker resected patella, and a less oval cut surface shape which gives better coverage for a domed prosthesis. Both methods however, gave a symmetric resection both superio-inferiorly as well as medio-laterally. Conclusions: Though TM appears statistically better with respect to the thickness and cut surface shape, only further intra-operative studies with long-term clinical follow up may provide us with the most appropriate patellar resection method.
more목차
TABLE OF CONTENTS
ABSTRACT ⅰ
TABLE OF CONTENTS iii
LIST OF FIGURES iv
LIST OF TABLES v
Ⅰ. INTRODUCTION 1
Ⅱ. MATERIALS AND METHODS 3
A. MATERIALS 3
1. SUBJECTS 3
B. METHODS 5
1. SETTING 5
2. STATISTICS 11
III. RESULTS 12
IV. DISCUSSION 14
Ⅴ. CONCLUSION 20
REFERENCES 21
국문요약 25
LIST OF FIGURES
Fig. 1. Reconstruction of 3-D CT images of the knee using specialized computer software 4
Fig. 2. Thickness of patella in the 3D image 6
Fig. 3. Subchondral method 7
Fig. 4. Anatomic landmarks chosen for resection at the fat fascia-tendon junctions for the tendon method of resection 8
Fig. 5. Measurement of ML symmetry and SI symmetry 10
Fig. 6. A schematic representation of the resection planes with the 2 methods 16
