X-ray Measurement Of Adult Knee Joint In Zhejiang Area

Objective:1.Research background and significance The measurement of human bones and joints is based on the measurement and recording of the human bone and joint system,and the comparison of measurement data between individuals and individuals,between groups and groups,to explore the correlation between bone and joint data on human individual development and related diseases.The meaning.The literature reports on Chinese bone and joint related measurements can be traced back to the 1950 s and 1960 s.Later,some scholars have updated the measured values of the skeletal system,but the current measurement values are limited due to the measurement area and the sample size is small.Factors such as inconsistent measurement standards and changes in the height of Chinese people cannot represent the normal range of bones and joints of Chinese people today.At the same time,with the development of society,precision medicine has become the consensus of everyone.Therefore,in order to obtain more scientific and accurate normal values of bone and joint,the work of re-verification and correction becomes very urgent and necessary.In order to obtain the relevant measurements of bone and joint in Chinese today,our hospital and Peking University Third Hospital jointly led the establishment of a national multi-center research team involving 15 cooperative units to conduct measurement and research on normal human bone muscle imaging data.According to the data of the Chinese Census,the sample size of each region is determined according to the region and population ratio.As one of the measurement units in East China,the hospital mainly measures the normal knee joint data in Zhejiang.2.Research purposes I hope that the normal value of the knee joint in Zhejiang area will be obtained through this measurement.At the same time,as a pre-experiment of collaborative research,we found and solved related problems in this experiment,and provided relevant support for national multi-center research.Methods: 1.Perform a preliminary experiment to determine the age range of the measurement First,determine the minimum age for the measurement.According to the national census data,the adult age group is divided into a youth group(18-29 years old),a middle-aged group(30-59 years old)and an elderly group(60 years old and above),three groups of 2:6:2,male The ratio of female and left and right sides was 1:1,and samples were selected according to this standard.The final 1006 patients were included in the preliminary study.During the measurement,it was found that when an adult(ie,18 years of age or older)in the legal sense was measured,there was a case where the epiphysis was not closed or not completely closed,and thus the age of the adult in the legal sense could not be equated with the age at which the epiphysis was closed.Normal adults with bone and joint measurements should be defined as those whose jaws are closed.Therefore,the opinions of anatomists are widely sought,and combined with the opinion of radiologists,the latest time for human osteophytes to be closed is 25 years old.The consensus is that the maturity of bones begins at the age of 25.Therefore,the minimum age measured is set to 25 years old.Second,determine the maximum age of the measurement.In 1006 pre-experimental databases,877 samples of age 25 years and older(including 25 years old)were selected,divided into 1 group(25-29 years old),2 groups(30-39 years old),and 3 groups(40-according to age).49 years old),4 groups(50-59 years old),5 groups(?60 years old).In the comparison of data of different age groups,it is found that all the values in Group 6 are statistically different from those in the previous groups,and some values in the other age groups are statistically different.Therefore,it is considered that the measurement values of the age group over 60 years old are The normal group is different and is excluded.Therefore,the age span of this study is 25-59 years old.According to the age group,there are four groups,namely 25-29 years old,30-39 years old,40-49 years old,50-59 years old.2.Determination of the sample size The determination of the official measurement sample size is mainly based on the proportion of the population of all age groups in the national data online in 2017.The proportion of each age group in this study is 25-29 years old,accounting for 16%,30-39 years old,accounting for 28%,40-49 years old,accounting for 31%.%,50-59 years old accounted for 25%.According to the sample size calculation formula,the allowable error is ?=0.05,?=0.05.According to the sampling sample calculation formula and the pre-experiment related results,the total theoretical sample size is 1135.In the actual calculation process,if there is still a remainder after the decimal point,it will directly carry in,so the actual measured sample size is 1143 cases.3.Screening the measured imaging images Image quality requirements: The orthotopic image of the knee requires the distal femur,the knee joint,and the proximal humerus;the knee joint is located in the center of the image,the humeral head and the tibia are slightly overlapped,and the soft tissue level is clear.The knee lateral image requirements include the distal femur,the knee joint space and the proximal humerus;the knee joint space is located at the center of the image;the humerus shows the lateral position,the tibia and femur gap is clear,the joint surface has no bilateral;femoral condyle and tibia The articular surface of the platform does not overlap or is extremely small;the soft tissue is clearly displayed.Exclusion criteria: imaging examination showed abnormal bone or bone defect;previous history of trauma,history of old bone disease caused by surgery;congenital malformation or disease;osteophytes were not closed;imaging images were not complete or image was not taken Qualified.4.Determination of measurement standards According to the above criteria,1143 cases of normal adult knee joint X-ray plain films were selected in Zhejiang area,and the relevant angle,length and gap were measured.When the angle index measurement is performed,the determination of the long axis of the long bone involving the angle is uniformly performed according to the following method.Measurement of the femoral angle,femoral angle,and humeral angle requires determination of the long axis of the femur and tibia.The first is the determination of the long axis of the femur.Since the femoral anatomical axis is closer to the anatomy of the femur,it is determined that the femoral anatomical axis is the long axis of the femur,and the femoral anatomical axis is the intersection of the center of the femur width and the center of the knee joint at 10 cm above the knee joint space.Two points were determined during the measurement,one of which is the center of the femur width at 10 cm above the knee joint.This point is easier to determine;the other point is the center of the knee joint,there are five in the center of the knee joint,and five knee joint centers in the predictive data.There was a statistical difference between the measured femoral angles(P<0.05).In order to reduce the error during measurement,the apex of the femoral intercondylar notch was selected as the center of the knee joint.This two-point connection is the long axis of the femur.Secondly,the long axis of the humerus is determined.Similarly,the center of the tibia width at 10 cm below the tibial plateau surface is selected.The connection between the point and the humerus is the long axis of the humerus.Tibial plateau angle: The angle between the perpendicular line of the extension line of the humeral shaft leading edge and the articular surface of the tibial plateau.There are three methods of measurement for this angle,and there is a statistical difference between the tibial plateau angles measured between the three in the literature.In order to reduce the error during measurement,the angle between the anterior cortical tangential line of the humerus and the tibial plateau joint surface is used.Femoral shaft angle: the angle between the axis of the femur and the long axis of the femoral condyle.The long axis of the femur was determined by the line connecting the center of the femur at 5 cm and 10 cm distal to the femur.The long axis of the femoral condyle was the line connecting the most prominent points before and after the femoral condyle.The medial and lateral space of the knee joint is the distance between the lowest point of the medial and lateral malleolus of the knee joint and the most concave point of the medial and lateral humerus;the transverse diameter of the medial and lateral femoral condyle is the distance between the medial and lateral iliac crest of the distal radius;the transverse diameter of the tibial plateau The distance between the medial and lateral sides of the tibial plateau;the IS index of the humerus is the ratio of the length of the superior iliac ligament and the height of the tibia.According to the above measurement standards,the PACS system's own angle and length measurement indicators are used for correlation measurement.5.Statistical methods Data were analyzed by SPSS 25.0 software,and the mean±standard deviation records were used.The t-test was used to compare the data.Pearson analysis was used to analyze the correlation between various indicators.P < 0.05 was statistically significant.The same diagnostician measured the measured values again at different times(2-4 weeks later)and different diagnosticians,and performed consistency analysis on the measured results.Results: 1.Sample size result A total of 1143 samples were included in the formal study,including 569 males and 574 females,573 and 574 left and right,respectively.Four age groups were 25-29 years old,30-39 years old,40-The number of people aged 49 and 50-59 was 212,310,330,and 291.2.X-ray measurement of adult knee joint in Zhejiang area The femoral angle averaged 175.74°±2.07°,the femoral angle averaged 83.13°±1.89°,the humeral angle averaged 92.12°±3.14°,the tibial plateau angle averaged 7.39°±3.77°,and the femoral condyle average angle was 98.82°.±3.58°,the medial and lateral space of the knee joint were 5.28mm±1.08 mm,5.05mm±1.01 mm,the transverse diameter of the medial and lateral femoral condyles was 79.53mm±7.05 mm,and the transverse diameter of the tibial plateau was 76.06mm±6.22 mm.The IS index averaged 1.05 ± 0.17.Among the measurements of the knee joint,the femoral angle,the medial and lateral space of the knee joint,the transverse diameter of the femoral condyle and the transverse diameter of the tibial plateau were statistically different between male and female(P<0.01),femoral condyle angle,humeral angle,femur.There was a statistically significant difference between the left and right sides of the sacral angle,the medial space of the knee joint and the lateral space of the knee joint(P<0.05).The femoral angle,the femoral condyle angle,the lateral space of the knee joint,and the lateral and lateral femoral condyles.The diameter of the radial and tibial plateau and the IS index of the tibia were statistically different between different age groups(P<0.05).Correlation between the measured values showed that there was a correlation between some measured values.3.Comparison of normal knee joint values in Zhejiang with domestic original data In addition to the sacral IS index,the knee joint measurements,such as the femoral angle,femoral angle,humeral angle,humeral plateau angle,femoral condyle angle,knee joint medial and lateral space,lateral and lateral humeral transverse diameter,tibial plateau transverse diameter,etc.Both were statistically different compared to previous data.4.Consistency test results The same doctor's measurement results at different times have good consistency,femoral angle,femoral angle,humeral angle,tibial plateau angle,femoral condyle angle,knee joint medial space,knee joint lateral space,femoral medial lateral malleolus transverse diameter,The ICC 95% confidence intervals for the transverse diameter of the tibial plateau and the IS index of the tibia were 0.741-0.861,0.793-0.874,0.817-0.905,0.792-0.923,0.860-0.915,0.805-0.951,0.808-0.952,0.840-0.910,0.797-,respectively.0.924,0.804,0.901.The results of different doctors at different times have good consistency.The femoral angle,femoral angle,humeral angle,tibial plateau angle,femoral condyle angle,medial knee joint space,knee joint lateral space,femoral medial lateral malleolus transverse diameter,tibial plateau The ICC 95% confidence intervals for the transverse diameter and tibia IS index were 0.705-0.853,0.777-0.870,0.798-0.856,0.653-0.864,0.734-0.859,0.709-0.878,0.779-0.845,0.718-0.880,0.791-0.898,0.777,respectively.-0.894.Conclusions: The normal measurement values of knee joints in Zhejiang and the differences between gender,side and age groups were obtained.Most of the knee measurements are statistically different from previous data,providing a more accurate basis for updating normal knee values.The above results provide theoretical and practical basis for further measurement and research of normal Chinese bone and joint imaging data.