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胫骨外旋增加与膝关节剥脱性骨软骨炎。

Increased external tibial torsion and osteochondritis dissecans of the knee.

作者信息

Bramer J A M, Maas M, Dallinga R J, te Slaa R L, Vergroesen D A

机构信息

Orthopaedic Research Center Amsterdam, Amsterdam, the Netherlands.

出版信息

Clin Orthop Relat Res. 2004 May(422):175-9. doi: 10.1097/01.blo.0000126310.02631.f2.

Abstract

In the past, osteochondritis dissecans of the knee was associated with increased tibial exotorsion, established with a clinical measuring method. Now the gold standard for determining tibial torsion is computed tomography. The aim of the current study was to establish whether the abovementioned association could be confirmed in the current patients, measured with computed tomography. Confounding aberrations of femoral torsion were ruled out. Twenty-three patients with osteochondritis dissecans in 27 knees were treated between 1991 and 1999. Symptoms and treatment results were comparable with those reported in the literature. Femoral and tibial torsion were measured with a computed tomography scan. The average femoral antetorsion was comparable with that in the literature. The average tibial exotorsion was significantly higher than the control value. Exotorsion was increased more in patients with bilateral osteochondritis, and extremely high in patients with persisting complaints. Increased tibial exotorsion could play a role in development of osteochondritis dissecans of the knee. Extreme exotorsion might be prognostic for persistent complaints.

摘要

过去,膝关节剥脱性骨软骨炎与胫骨外旋增加有关,这是通过临床测量方法确定的。现在,确定胫骨扭转的金标准是计算机断层扫描。本研究的目的是确定上述关联在当前患者中是否可以通过计算机断层扫描测量得到证实。排除了股骨扭转的混杂异常。1991年至1999年间,对27个膝关节患有剥脱性骨软骨炎的23名患者进行了治疗。症状和治疗结果与文献报道的相当。通过计算机断层扫描测量股骨和胫骨扭转。平均股骨前倾角与文献中的相当。平均胫骨外旋明显高于对照值。双侧剥脱性骨软骨炎患者的外旋增加更多,而持续有症状的患者外旋极高。胫骨外旋增加可能在膝关节剥脱性骨软骨炎的发展中起作用。极度外旋可能是持续有症状的预后指标。

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