髌股疼痛患者的股骨形态与髌股运动学的相关性。

Correlating femoral shape with patellar kinematics in patients with patellofemoral pain.

机构信息

Biomedical Engineering Department, University of Michigan, College of Engineering, 648 Lyon Blvd, South Lyon, Michigan 48178, USA.

出版信息

J Orthop Res. 2010 Jul;28(7):865-72. doi: 10.1002/jor.21101.

Abstract

The etiology of patellofemoral pain is likely related to pathological femoral shape and soft-tissue restraints imbalance. These factors may result in various maltracking patterns in patients with patellofemoral pain. Thus, we hypothesized that femoral shape influences patellofemoral kinematics, but that this influence differs between kinematically unique subgroups of patients with patellofemoral pain. 3D MRIs of 30 knees with patellofemoral pain and maltracking ("maltrackers") and 33 knees of asymptomatic subjects were evaluated, retrospectively. Dynamic MRI was acquired during a flexion-extension task. Maltrackers were divided into two subgroups (nonlateral and lateral maltrackers) based on previously defined kinematic criteria. Nine measures of femoral trochlear shape and two measures of patellar shape were quantified. These measures were correlated with patellofemoral kinematics. Differences were found in femoral shape between the maltracking and asymptomatic cohorts. Femoral shape parameters were associated with patellar kinematics in patients with patellofemoral pain and maltracking, but the correlations were unique across subgroups within this population. The ability to better categorize patients with patellofemoral pain will likely improve treatment by providing a more specific etiology of maltracking in individual patients.

摘要

髌股疼痛的病因可能与病理性股骨形态和软组织约束失衡有关。这些因素可能导致髌股疼痛患者出现各种轨迹异常。因此,我们假设股骨形态会影响髌股运动学,但这种影响在髌股疼痛患者的运动学独特亚组之间存在差异。回顾性评估了 30 例髌股疼痛伴轨迹异常(“轨迹异常者”)和 33 例无症状受试者的膝关节 3D MRI。在屈伸任务中采集动态 MRI。根据先前定义的运动学标准,将轨迹异常者分为两个亚组(非外侧轨迹异常者和外侧轨迹异常者)。量化了 9 项股骨滑车形态测量值和 2 项髌骨形态测量值。这些测量值与髌股运动学相关。在轨迹异常者和无症状队列之间发现了股骨形态的差异。在髌股疼痛伴轨迹异常的患者中,股骨形态参数与髌骨运动学相关,但在该人群的亚组内,相关性是独特的。更好地对髌股疼痛患者进行分类的能力可能会通过为个体患者提供轨迹异常的更具体病因来改善治疗。

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