Kang Huijun, Lu Jiangfeng, Li Faquan, Dai Yike, Dong Zhenyue, Dong Conglei, Wang Fei
Department of Joint Surgery, Third Hospital of Hebei Medical University, Ziqiang Road 139, 050051 Shijiazhuang, China.
J Adv Res. 2020 Feb 13;23:143-149. doi: 10.1016/j.jare.2020.02.002. eCollection 2020 May.
Increased femoral anteversion (FA) has been recently demonstrated as one risk factor for recurrent patellar dislocation (RPD). However, it has been still unclear whether the increase of FA can result in patellar dislocation, and subsequent morphological and trabecular microarchitectural changes in the trochlea has not been investigated. Forty knees from 20 rabbits at 3 months of age were included. The right knees underwent surgery with internal rotation of distal femur to increase FA, with the left knees acting as internal controls. The surgical knees were called operated group, and non-operated knees were control group. Micro-CT scans for distal femur were acquired after 4 months of surgery. In the operated group, a boss located proximal to the entrance of the groove was formed. The central trochlear height was significantly greater, sulcus angle was significantly greater, both lateral and medial trochlear slope were significantly lower, and boss height was significantly greater in comparison to the control group. Regarding the microarchitectural changes, the trabecular thickness were increased by 67.5% at the groove, 33.0% and 29.5%, at the medial and lateral femoral condyle, and trabecular number were decreased by 37.8% and 26.5% at the groove and medial femoral condyle. This study provided a novel animal model of trochlea dysplasia by femoral rotational osteotomy and increased FA. These changes were associated with the load redistribution in the patellofemoral joint after the increase of FA.
最近研究表明,股骨前倾增加(FA)是复发性髌骨脱位(RPD)的一个风险因素。然而,FA增加是否会导致髌骨脱位仍不清楚,并且尚未对滑车随后的形态学和小梁微结构变化进行研究。纳入了20只3月龄兔子的40个膝关节。右膝进行手术,使股骨远端内旋以增加FA,左膝作为自身对照。手术的膝关节称为手术组,未手术的膝关节为对照组。术后4个月对股骨远端进行显微CT扫描。在手术组中,在滑车沟入口近端形成了一个凸起。与对照组相比,手术组中央滑车高度显著更高,沟角显著更大,外侧和内侧滑车斜率均显著更低,凸起高度显著更高。关于微结构变化,滑车沟处小梁厚度增加了67.5%,股骨内侧髁和外侧髁处分别增加了33.0%和29.5%,滑车沟和股骨内侧髁处小梁数量分别减少了37.8%和26.5%。本研究通过股骨旋转截骨术和增加FA提供了一种新的滑车发育不良动物模型。这些变化与FA增加后髌股关节的负荷重新分布有关。