Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2013 Aug;21(8):1841-8. doi: 10.1007/s00167-012-2163-7. Epub 2012 Aug 10.
The geometry of the trochlear groove is considered to be an important determinant in the pathogenesis of the patellofemoral joint disorders. However, the effect of patellar position during the development of the femoral trochlear groove is unclear. This animal study aimed to investigate the relationship between the position of the patella and development of the femoral trochlear groove in growing rabbits.
Thirty-two knees from 16 rabbits were included in this study and were divided into two groups. First group consisted of the left knees and was used as a control group with no surgical interventions. The second group involved the right knees on which patellar tendon Z-plasty lengthening was performed to cause patellar malposition (patella alta) before 1 month of age. Computed tomographic (CT) evaluations of both knees were obtained when the animals were 1 month age before the surgical intervention and also at 6 months after the surgical intervention. Angle and depth measurements were acquired from the proximal, middle, and distal reference points along the femoral trochlear groove. After the CT scan acquisition at 6 months following the surgical procedures, rabbits were killed and additional measurements of the trochlear groove angles were performed manually.
The mean middle and distal trochlear groove angles for the experiment group with patella alta were significantly higher compared to that of control group (p < 0.017). The increase in mean trochlear depth for the animals in the control group was found to be significantly higher compared to experiment group at the distal zone (p < 0.017).
Distal femoral groove with an inadequately positioned patella becomes more flattened and this may be a predisposing factor for patellar instability.
Controlled laboratory study, Level II.
滑车沟的几何形状被认为是髌股关节紊乱发病机制的重要决定因素。然而，滑车沟在髌股关节发育过程中，髌骨位置的影响尚不清楚。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 16 只兔子的 32 个膝关节，分为两组。第一组包括左侧膝关节作为对照组，无手术干预。第二组涉及右侧膝关节，在 1 个月龄前进行髌腱 Z 成形术延长，导致髌骨位置不当（高位髌骨）。在手术干预前 1 个月和手术干预后 6 个月时，对双侧膝关节进行计算机断层扫描（CT）评估。在股骨滑车沟的近端、中间和远端参考点获取角度和深度测量值。在手术程序后 6 个月进行 CT 扫描采集后，处死兔子并手动进行滑车沟角度的进一步测量。
高位髌骨实验组的滑车沟中部和远端平均角度明显高于对照组（p<0.017）。与实验组相比，对照组在远端区域的滑车沟平均深度增加更为显著（p<0.017）。
未正确定位的髌骨导致股骨远端滑车沟变平，这可能是髌骨不稳定的一个诱发因素。
对照实验室研究，II 级。
