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青少年股骨滑车发育不良与胫股关节形态的相关性。

Association of Femoral Trochlear Dysplasia and Tibiofemoral Joint Morphology in Adolescent.

机构信息

Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).

Department of Neurology, Beijing Zhongguancun Hospital, Beijing, China (mainland).

出版信息

Med Sci Monit. 2019 Mar 8;25:1780-1787. doi: 10.12659/MSM.913600.

Abstract

BACKGROUND Trochlear dysplasia (TD) often leads to anatomic variations of the knee. Little is known about the association of TD and tibiofemoral joint morphology in adolescent. MATERIAL AND METHODS Computed tomography scans of 35 knees with TD and 55 knees with well-developed patella-femoral joint were analyzed randomly and retrospectively. Two researchers evaluated the posterior tibial slope (PTS), distal femoral rotation, proximal tibia varus angle, and femoral anteversion between the 2 groups. The independent Student's t-test was used to evaluate the statistical significance of variables. RESULTS The study group had a smaller lateral PTS (4.7±2.97) than the control group (6.96±3.05) (P<0.01), while the medial PTS showed consistent values between the control and the study group (non-significant). Patients with TD had smaller external rotation of the distal femur (2.69±0.93) compared to the control group (3.77±1.46) (P<0.01). In addition, the study group showed a bigger proximal tibia varus angle (4.46±1.09) compared to the control group (3.35±0.76) (P<0.01). The femoral anteversion in the study group (17.46±9.95) was increased compared to the control group (12.22±5.39) (P<0.01). The femoral anteversion and distal femoral rotation in patients with TD showed a positive correlation (r²=0.326; P<0.001). CONCLUSIONS Patients with TD had flatter lateral PTS compared to those without TD, but there were no differences in the medial PTS between the two groups. Patients with TD had smaller distal femoral rotation and bigger proximal tibia varus angle. The femoral anteversion in patients with TD was bigger than those without TD,and there was a positive correlation between the femoral anteversion and the external rotation of the distal femoral in the study group.

摘要

背景

滑车发育不良(TD)常导致膝关节解剖结构发生变化。青少年 TD 与髌股关节形态的相关性知之甚少。

材料和方法

对 35 例 TD 膝关节和 55 例髌股关节发育良好的膝关节进行随机回顾性 CT 扫描分析。两名研究人员评估了两组间的胫骨后倾角(PTS)、股骨远端旋转、胫骨近端内翻角和股骨前倾角。采用独立样本 t 检验评估变量的统计学意义。

结果

研究组的外侧 PTS(4.7±2.97)小于对照组(6.96±3.05)(P<0.01),而内侧 PTS 在对照组和研究组之间有一致的值(无显著性差异)。TD 患者的股骨远端外旋(2.69±0.93)较对照组(3.77±1.46)小(P<0.01)。此外,研究组的胫骨近端内翻角(4.46±1.09)较对照组(3.35±0.76)大(P<0.01)。研究组的股骨前倾角(17.46±9.95)较对照组(12.22±5.39)大(P<0.01)。TD 患者的股骨前倾角和股骨远端旋转呈正相关(r²=0.326;P<0.001)。

结论

与无 TD 的患者相比,TD 患者的外侧 PTS 更平坦,但两组间内侧 PTS 无差异。TD 患者的股骨远端旋转较小,胫骨近端内翻角较大。TD 患者的股骨前倾角大于无 TD 的患者,且研究组的股骨前倾角与股骨远端外旋呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1262/6419534/66c0956057c4/medscimonit-25-1780-g001.jpg

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