Wang Xiao-Meng, Liu Hui-Xin, Niu Jing-Hui, Duan Gu-Man, Wang Fei
Department of Orthopedics, Third Hospital of Hebei Medical University, Shijiazhuang, China.
Orthop Surg. 2016 Nov;8(4):468-474. doi: 10.1111/os.12290.
To investigate the anatomic morphology of the patellar ridge and how it matches the femoral trochlea in patellar tracking.
We selected 40 volunteers, 20 males (age, 28 ± 5 years) and 20 female (age, 27 ± 6 years), who were completely asymptomatic with normal knee structures. We measured the right or left legs of volunteers, and the region from the distal femur to the tibial tuberosity was scanned by computed tomography (CT) with flexion at 0°, 30°, 60°, and 90°. CT data was reconstructed using image analysis software (Mimics). Variables such as the angle between the patellar ridge and patellar long axis, the tibial external rotation angle, as well as the best matching position between the patellar ridge and femoral trochlea at different knee flexion angles were measured. A single experienced orthopedic surgeon performed all the measurements, and the surgeon was blinded to the subject identifying information. We analyzed the differences between the various angles using a one-way analysis of variance. The differences between genders were analyzed using the t test.
The intraclass correlation coefficient (ICC) values were greater than 0.81 for all measurements, and the ICC value is almost in perfect agreement. The angle between the patellar ridge and the patellar long axis was 11.13° ± 4.1°. The angle in male participants was 10.87° ± 4.5° and it was 12.09° ± 3.7° in female participants. There were significant differences between each angle (0°, 30°, 60°, and 90°). The angles between the patellar ridge and femoral trochlear groove did not greatly increase with the knee flexion. The tibial internal rotation angle also showed a gradually increase at knee flexion of 0°-60°, and a gradually decrease at 60°-90°. The best-fit point between the patellar ridge and femoral trochlear groove gradually increased along with the knee flexion. There were no significant differences between male and female participants at all angles ( P < 0.05).
The anatomic morphology of the patellar ridge allows better matching between the patellar ridge and femoral trochlea during knee flexion, which is an important mechanism for the regulation of patellar tracking.
研究髌嵴的解剖形态及其在髌骨轨迹中与股骨滑车的匹配情况。
我们选取了40名志愿者，其中20名男性（年龄28±5岁）和20名女性（年龄27±6岁），他们膝关节结构正常且完全无症状。我们测量了志愿者的右下肢或左下肢，通过计算机断层扫描（CT）在0°、30°、60°和90°屈曲位扫描从股骨远端到胫骨结节的区域。使用图像分析软件（Mimics）重建CT数据。测量诸如髌嵴与髌骨长轴之间的角度、胫骨外旋角度以及不同膝关节屈曲角度下髌嵴与股骨滑车的最佳匹配位置等变量。由一名经验丰富的骨科医生进行所有测量，该医生对受试者识别信息不知情。我们使用单因素方差分析分析各角度之间的差异。使用t检验分析性别之间的差异。
所有测量的组内相关系数（ICC）值均大于0.81，ICC值几乎完全一致。髌嵴与髌骨长轴之间的角度为11.13°±4.1°。男性参与者的角度为10.87°±4.5°，女性参与者的角度为12.09°±3.7°。各角度（0°、30°、60°和90°）之间存在显著差异。髌嵴与股骨滑车沟之间的角度并未随着膝关节屈曲而大幅增加。胫骨内旋角度在膝关节屈曲0°至60°时也逐渐增加，在60°至90°时逐渐减小。髌嵴与股骨滑车沟之间的最佳拟合点随着膝关节屈曲逐渐增加。所有角度下男性和女性参与者之间均无显著差异（P<0.05）。
髌嵴的解剖形态使得在膝关节屈曲过程中髌嵴与股骨滑车之间能更好地匹配，这是调节髌骨轨迹的重要机制。
