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股骨远端和胫骨近端关节面尺寸对膝关节骨关节炎发展的影响。

The effect of the dimensions of the distal femur and proximal tibia joint surfaces on the development of knee osteoarthritis.

作者信息

Işik Derya, Işik Çetin, Apaydin Nihal, Üstü Yusuf, Uğurlu Mahmut, Bozkurt Murat

机构信息

Family Medicine Clinic, Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.

Orthopaedics and Traumatology Clinic, Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.

出版信息

Clin Anat. 2015 Jul;28(5):672-7. doi: 10.1002/ca.22550. Epub 2015 Apr 23.

Abstract

The aim of this study was to determine whether the dimensions of the distal femur and proximal tibia joint surfaces affect the etiology of knee osteoarthritis (OA). The study comprised the records of 1,324 patients who had been admitted to hospital with knee pain. Anterioposterior (AP) and lateral radiographs of the knee were taken. Using the Kellgren-Lawrence Scale, the patient group comprised Stages 2, 3, and 4 radiographs and the controls comprised Stages 0 and 1 radiographs. Four lengths were measured for each patient in both groups: femur mediolateral (femur ML), tibia mediolateral (tibia ML), femur anteroposterior (femur AP), and tibia anteroposterior (tibia AP). Osteophytes were not included in the measurements in the patient group. All the measurements were repeated by two researchers at two different times. The groups were compared in terms of these measurements and the correlations between them. The mean femur ML length was significantly greater in the patient group than the control group (P = 0.032) and the mean femur AP length was significantly less (P = 0.037). In addition, the difference between the femur ML and AP lengths was significantly high in the patient group (P < 0.001). The difference between the tibia and femur ML lengths was significantly high in the patient group (P < 0.001) and the difference between the tibia and femur AP lengths was higher in the control group (P = 0.001). A longer femur ML and a shorter femur AP, together with a greater difference between these two lengths and a greater difference between the tibia ML and femur ML lengths, could be a risk factor for developing knee OA. More extensive anatomical and biomechanical studies in the future will enable these results to be corroborated.

摘要

本研究的目的是确定股骨远端和胫骨近端关节面的尺寸是否会影响膝关节骨关节炎(OA)的病因。该研究纳入了1324例因膝关节疼痛入院的患者记录。拍摄了膝关节的前后位(AP)和侧位X线片。根据Kellgren-Lawrence量表,患者组包括2、3和4期X线片,对照组包括0和1期X线片。对两组中每位患者测量四个长度:股骨内外侧(股骨ML)、胫骨内外侧(胫骨ML)、股骨前后位(股骨AP)和胫骨前后位(胫骨AP)。患者组的测量中未包括骨赘。所有测量均由两名研究人员在两个不同时间重复进行。比较了两组在这些测量值及其之间相关性方面的差异。患者组的平均股骨ML长度显著大于对照组(P = 0.032),平均股骨AP长度显著小于对照组(P = 0.037)。此外,患者组中股骨ML和AP长度之间的差异显著更高(P < 0.001)。患者组中胫骨与股骨ML长度之间的差异显著更高(P < 0.001),而对照组中胫骨与股骨AP长度之间的差异更高(P = 0.001)。较长的股骨ML和较短的股骨AP,以及这两个长度之间的更大差异和胫骨ML与股骨ML长度之间的更大差异,可能是发生膝关节OA的危险因素。未来更广泛的解剖学和生物力学研究将能够证实这些结果。

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