Teichtahl A J, Parkins K, Hanna F, Wluka A E, Urquhart D M, English D R, Giles G G, Cicuttini F M
Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, Victoria 3004, Australia.
Osteoarthritis Cartilage. 2007 Oct;15(10):1158-62. doi: 10.1016/j.joca.2007.03.010. Epub 2007 Apr 27.
Although the geometry of the trochlear groove is considered important in the pathogenesis of patellofemoral joint pathology it is unclear how the shape of the trochlear groove relates to patella morphology. This cross-sectional study investigated the relationship between the shape of the trochlear groove and patella cartilage and bone morphology in healthy adults.
Two hundred and ninety-seven healthy adults aged between 50 and 79 years with no clinical history of knee pain or pathology were examined using magnetic resonance imaging (MRI). From the magnetic resonance (MR) images, the bony angles formed at the distal and proximal trochlear groove were measured, together with patella cartilage and bone volumes and patella cartilage defects.
After adjustment for potential confounders, there was an 8.70mm(3) (95% confidence interval (CI) 2.15, 15.26) increase in patella cartilage volume (P=0.009), with no increased prevalence of cartilage defects (odds ratio=0.99 (95% CI 0.96, 1.02), P=0.35), for every 1 degrees increase (i.e., as the angle became more flatter) at the distal trochlear groove. Moreover, there was a 53.86mm(3) (95% CI -90.26, -17.46) reduction in patella bone volume for every 1 degrees that the angle at the distal trochlear groove became more flattened (P=0.004). No significant association between the proximal trochlear groove angle and the patella cartilage or bone properties was observed.
A more flattened bony angle at the distal trochlear groove was associated with increased patella cartilage volume and reduced patella bone volume, but no increased prevalence of patella cartilage defects in adults with no history of knee pain or clinical disease. These cross-sectional findings suggest that a flattened distal trochlear groove may protect against degenerative patellofemoral conditions, such as osteoarthritis, but this will need to be confirmed in a longitudinal study.
虽然滑车沟的几何形状在髌股关节病变的发病机制中被认为很重要，但目前尚不清楚滑车沟的形状与髌骨形态之间的关系。这项横断面研究调查了健康成年人滑车沟形状与髌骨软骨及骨形态之间的关系。
对297名年龄在50至79岁之间、无膝关节疼痛或病变临床病史的健康成年人进行了磁共振成像（MRI）检查。从磁共振（MR）图像中，测量了滑车沟远端和近端形成的骨角，以及髌骨软骨和骨体积及髌骨软骨缺损情况。
在对潜在混杂因素进行调整后，滑车沟远端角度每增加1度（即角度变得更平坦），髌骨软骨体积增加8.70mm³（95%置信区间（CI）2.15，15.26）（P = 0.009），软骨缺损患病率未增加（优势比 = 0.99（95% CI 0.96，1.02），P = 0.35）。此外，滑车沟远端角度每变得更平坦1度，髌骨骨体积减少53.86mm³（95% CI -90.26，-17.46）（P = 0.004）。未观察到滑车沟近端角度与髌骨软骨或骨特性之间存在显著关联。
滑车沟远端骨角更平坦与髌骨软骨体积增加和髌骨骨体积减少相关，但在无膝关节疼痛或临床疾病病史的成年人中，髌骨软骨缺损患病率未增加。这些横断面研究结果表明，更平坦的滑车沟远端可能预防髌股关节的退行性疾病，如骨关节炎，但这需要在纵向研究中得到证实。
