Faculty of Medicine, Department of Orthopaedics and Traumatology, Hacettepe University, Sihhiye, Ankara, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2012 Feb;20(2):232-8. doi: 10.1007/s00167-011-1603-0. Epub 2011 Jul 20.
The geometry of an articular surface is an important determinant of joint function. Although the geometry of the trochlear groove is considered to be important in the pathogenesis of patellofemoral joint disorders, the effects of the patella during the development of the femoral trochlear groove are unclear. This animal study aimed to investigate the relationship between the position of the patella and development of femoral trochlear groove in growing rabbits.
Twenty-four knees of 12 rabbits were included in this study and were divided into two groups. First group consisted of the left knees and was used as the control group to which no surgical procedures were applied. Second group involved the right knees to which medial soft tissue restraints release was applied before 1 month of age. Computed tomographic (CT) evaluation of both knees of each rabbit was made in their first month of age before medial retinacular release and also during post-op 1-year follow-up. CT measurements included both the angle and depth of the femoral trochlear groove from 3 different parts (proximal, middle and distal) of the distal femur, and then these measurements were averaged.
Measurements revealed that while in the control group the groove angle decreased 27.4 degrees and the depth increased 0.11 mm, in the operated counterparts groove angle decreased 16.8 degrees and groove depth increased 0.03 mm, which indicated the flattening of the femoral groove in the operated group. These differences were found to be statistically significant (P < 0.05).
The results indicated that distal femoral groove with inadequate patellar position becomes more flattened and causes predisposition for patellar instability. Consequently, the clinical relevance of this study was that early reconstruction of the patellofemoral joint should be performed in the childhood to prevent the patellofemoral problems that are likely to be encountered in the following years.
关节面的几何形状是关节功能的重要决定因素。虽然滑车沟的几何形状被认为是髌股关节紊乱发病机制中的一个重要因素,但是髌骨在股骨滑车沟发育过程中的作用尚不清楚。本动物研究旨在探讨髌骨位置与生长兔股骨滑车沟发育之间的关系。
本研究纳入 12 只兔子的 24 个膝关节,将其分为两组。第一组包括左侧膝关节作为对照组,不进行任何手术。第二组涉及右侧膝关节,在 1 个月龄之前进行内侧软组织松解。在进行内侧支持带松解前(即 1 月龄)和术后 1 年随访时,对每只兔子的双膝进行计算机断层扫描(CT)评估。对每只兔子的双膝进行 CT 测量,包括股骨远端 3 个不同部位(近端、中部和远端)的滑车沟角度和深度,然后对这些测量值进行平均。
测量结果表明,在对照组中,沟角减小 27.4 度,深度增加 0.11 毫米,而在手术组中,沟角减小 16.8 度,沟深度增加 0.03 毫米,表明手术组股骨沟变平。这些差异具有统计学意义(P < 0.05)。
研究结果表明,位置不当的股骨远端滑车沟变得更加平坦,容易导致髌骨不稳定。因此,本研究的临床意义在于,儿童时期应早期重建髌股关节,以预防未来数年可能出现的髌股问题。