Department of Orthopaedic Surgery, Lapeyronie University Hospital, Montpellier University, 371 Av du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme, 20 College Road, Academia Level 4, Singapore, 169865, Singapore.
Knee Surg Sports Traumatol Arthrosc. 2021 Nov;29(11):3793-3799. doi: 10.1007/s00167-020-06413-7. Epub 2021 Jan 15.
Previous investigations suggested that femoral side-to-side differences were located in the upper femur anatomy. However, little is known about the asymmetry between distal femur and patella. The degree of bony asymmetry in the patellofemoral joint was evaluated using pairs of CT-scans with emphasis on morphometric measurements and risk factors relevant to patellofemoral disorders.
Patellofemoral morphometric parameters and anatomical risk factors were analyzed from 345 pairs of CT scans to evaluate side-to-side differences for each patient. All measurements were automatized using previously published algorithm-calculated bone landmarks. We analyzed asymmetry based on absolute differences (AD) and percentage asymmetry (AS%). Significant asymmetry was defined as AS% > 10%.
Patellar height was found to be highly symmetric (mean AD 0.1 for both Insall-Salvatti and Caton-Deschamps methods, AS% 8% and 9%, respectively). Patellar and femoral morphometric parameters were found highly symmetric, except for the trochlear groove depth. Substantial asymmetry was reported in two patellofemoral risk factors: the lateral trochlear inclination (mean AD 2°, AS% 16%) and the tibial tuberosity-trochlear groove distance (1 mm, 116%). Patellar and femoral morphometric asymmetries were independent of demographics, including age, gender, height, weight and ethnicity.
Patellar height was found to be highly symmetric and is, therefore, a reasonable index for contralateral templating. While very few patellofemoral morphometric parameters and anatomical risk factors were asymmetric, the mean differences were clinically negligible and independent of demographics.
III.
之前的研究表明，股骨的侧别差异位于股骨上段解剖结构中。然而，对于股骨远端和髌骨之间的不对称性知之甚少。本研究使用 CT 扫描对髌股关节的骨不对称程度进行评估，重点关注与髌股关节紊乱相关的形态测量和解剖学危险因素。
对 345 对 CT 扫描进行髌股形态测量参数和解剖学危险因素分析，以评估每位患者的侧别差异。所有测量均使用之前发表的算法计算的骨标志点进行自动测量。我们基于绝对差值（AD）和百分比不对称（AS%）来分析不对称性。AS%＞10%定义为显著不对称。
髌股高度具有高度对称性（Insall-Salvatti 和 Caton-Deschamps 方法的平均 AD 分别为 0.1，AS%分别为 8%和 9%）。髌骨和股骨形态测量参数也具有高度对称性，除滑车沟深度外。两个髌股关节危险因素存在明显的不对称性：外侧滑车倾斜角（平均 AD 2°，AS% 16%）和胫骨结节-滑车沟距离（1mm，116%）。髌股形态测量不对称与年龄、性别、身高、体重和种族等人口统计学因素无关。
髌股高度具有高度对称性，因此是对侧模板的合理指标。虽然很少有髌股形态测量参数和解剖学危险因素存在不对称，但平均差异在临床上可以忽略不计，且与人口统计学因素无关。
III 级。
