Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
J Orthop Surg Res. 2021 Feb 10;16(1):128. doi: 10.1186/s13018-021-02251-6.
Whether vastus medialis obliquus atrophy exists in patients with patellofemoral pain syndrome and whether the amount of atrophy differs between the vastus medialis obliquus and vastus lateralis muscles remain unknown.
From June 2016 to March 2019, 61 patients with patellofemoral pain syndrome were retrospectively included in the study group, and an age-, sex-, and body mass index-matched cohort of 61 patients with normal knees was randomly selected as the control group. All enrolled subjects had undergone CT scans in the supine position. The cross-sectional areas of the vastus medialis obliquus and the vastus lateralis muscle in the sections 0, 5, 10, 15, and 20 mm above the upper pole of the patella were measured, and the vastus medialis obliquus/vastus lateralis muscle area ratio was evaluated.
In the study group, the vastus medialis obliquus areas and the vastus lateralis muscle areas in the sections that were 0, 5, 10, 15, and 20 mm above the upper pole of the patella were significantly smaller than the respective areas in the control group (P < 0.05). The vastus medialis obliquus/vastus lateralis muscle area ratio was significantly smaller at the upper pole of the patella (the section 0 mm above the upper pole of the patella) than the corresponding ratio in the control group (P < 0.05). No significant difference was noted between the two groups in the sections 5, 10, 15, and 20 mm above the upper pole of the patella (P > 0.05).
In patients with patellofemoral pain syndrome, vastus medialis obliquus and vastus lateralis muscle atrophy existed in sections 0-20 mm above the upper pole of the patella, compared with normal controls, and atrophy of the vastus medialis obliquus was more evident than that of the vastus lateralis muscle at the upper pole of the patella. These findings support the rationale for the use of general quadriceps exercise combined with vastus medialis obliquus strengthening exercise as part of the rehabilitation programme for the patients with patellofemoral pain syndrome.
髌股疼痛综合征患者是否存在股内侧斜肌萎缩,以及股内侧斜肌和股外侧肌的萎缩程度是否存在差异,目前尚不清楚。
本研究回顾性纳入 2016 年 6 月至 2019 年 3 月间 61 例髌股疼痛综合征患者作为研究组,同期随机选取 61 例膝关节正常的患者作为对照组。所有纳入患者均行仰卧位 CT 扫描,测量髌上极上方 0、5、10、15、20mm 处股内侧斜肌和股外侧肌的横截面积,并评估股内侧斜肌/股外侧肌面积比。
研究组患者在髌上极上方 0、5、10、15、20mm 处的股内侧斜肌面积和股外侧肌面积均明显小于对照组(P<0.05)。髌上极处(髌上极上方 0mm 处)股内侧斜肌/股外侧肌面积比明显小于对照组(P<0.05)。而在髌上极上方 5、10、15、20mm 处,两组间差异无统计学意义(P>0.05)。
与正常对照组相比,髌股疼痛综合征患者的股内侧斜肌和股外侧肌在髌上极上方 0-20mm 处均存在萎缩,且股内侧斜肌的萎缩比股外侧肌更明显。这些发现支持将一般股四头肌锻炼与股内侧斜肌强化锻炼相结合作为髌股疼痛综合征康复计划的一部分的理念。