Anatomical And Morphological Characteristics Of Knee Joint In Hemophilic Arthritis Patients

Background: Hemophilia is a rare genetic disorder,this illness were most commonly found in patients when they were children.On account of malpractice,majority die in childhood or adolescence.Along with the unceasing technical progress,more and more advanced technologies are applied to improve the therapy quality and make hemophiliacs live longer.Unfortunately,the high cost of treatment that disease reached to terminal stage.Leading to severe hemophiliac arthritis.Total knee replacement has been the gold standard for end-stage hemophiliac arthritis.Make hemophiliacs have painless and flexible articulatio genus to improve the quality of life.The number of total knee arthroplasty in hemophiliac arthritis patients is increasing,but there has been no report on the morphological analysis of knee joints in hemophilic arthritis patients.Objective: To provide reference data for the design of knee prosthesis for hemophilic arthritis patients through the measurement of knee three-dimensional CT anatomical morphological parameters and X-ray.Methods: A retrospective analysis of 46 cases of knee thin-section CT images and X-ray anteroposterior stand-up radiograph of lower limbs was conducted,including 23 cases of hemophilia patients and 23 cases of ordinary patients.Those patients were measured by three-dimensional software for the femoral lateral anteroposterior diameter,width of lateral condyle,femoral medial anteroposterior diameter,width of medial condyle,tibial anteroposterior diameter,tibial mediolateral width,tibial medial anteroposterior line,and tibial lateral anteroposterior.The following measurements were obtained on anteroposterior stand-up radiograph of lower limbs: the anatomical femoral-tibial angle,lateral distal femoral angle,and medial proximal tibial angle.The morphological differences between the two groups were compared and analyzed.Results:(1)The tibial medial anteroposterior line,tibial anteroposterior diameter,the anatomical femoral-tibial angle,and medial proximal tibial angle were smaller in the hemophiliac group than those in the ordinary group,and there were significant difference(P < 0.05).(2)The femoral lateral anteroposterior diameter and femoral medial anteroposterior diameter of the hemophiliac group were both smaller than those in the ordinary group;while width of lateral condyle and width of medial condyle were larger in the hemophiliac group than those in the ordinary group(P < 0.001).Conclusion:The results showed that the anatomical morphology of proximal tibia and distal femur in the hemophiliac group was different from that in the ordinary group.The proximal medial wear of tibia was more severe in the hemophiliac group than in the control group,while the distal medial and lateral femoral condyles were wider in the hemophiliac group than in the ordinary group.In addition,the aspect ratio of the distal femur is relatively small.