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儿童和青少年首次急性外侧髌骨脱位:未受影响膝关节的髌股关节解剖异常情况如何?

First-Time Acute Lateral Patellar Dislocation in Children and Adolescents: What About Unaffected Knee Patellofemoral Joint Anatomic Abnormalities?

作者信息

Simonaitytė Rasa, Rutkauskas Saulius, Čekanauskas Emilis, Labanauskas Liutauras, Barauskas Vidmantas

机构信息

Department of Pediatric Surgery, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.

Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2021 Feb 26;57(3):206. doi: 10.3390/medicina57030206.

Abstract

Acute lateral patellar dislocation (LPD) is the most common acute knee disorder in children and adolescents, and may lead to functional disability. The purpose of this study was to identify key differences and correlations of the patellofemoral joint (PFJ) morphology between intact and contralateral injured knees in a first-time traumatic LPD population aged under 18 years. The data were gathered prospectively from a cohort of 58 patients (35 girls and 23 boys). The prevalence and combined prevalence of patella alta (PA) and trochlear dysplasia (TD) in both knees of patients were evaluated using X-ray by two radiologists. The PFJ of patients' intact knees had a lower rate of TD (1.72% vs. 5.2%) and a less common combination of PA with shallow femoral sulcus (SFS) (22.4% vs. 44.8%) but more frequent PA (62.1% vs. 41.4%) compared with their injured knees. We noted statistically significant positive correlations (SSPCs) between the femoral sulcus angle (FSA) and PA in patients with intact ( = 0.37; < 0.005) and contralateral injured knees ( = 0.33; < 0.05). There were SSPCs between the FSA and PA in both gender and age groups of patients with intact and contralateral injured knees. The SSPCs between the FSA and PA of intact knees were higher in the patients with a more dysplastic PFJ anatomy (PA and TD) of the injured knees as compared to patients with only PA of the injured knees.

摘要

急性外侧髌骨脱位(LPD)是儿童和青少年中最常见的急性膝关节疾病,可能导致功能残疾。本研究的目的是确定18岁以下首次创伤性LPD人群中,患侧与对侧未受伤膝关节之间髌股关节(PFJ)形态的关键差异和相关性。前瞻性收集了58例患者(35名女孩和23名男孩)的数据。由两名放射科医生使用X射线评估患者双膝关节中高位髌骨(PA)和滑车发育不良(TD)的患病率及合并患病率。与受伤膝关节相比,患者未受伤膝关节的PFJ中TD发生率较低(1.72%对5.2%),PA与浅股骨沟(SFS)的合并情况较少见(22.4%对44.8%),但PA更常见(62.1%对41.4%)。我们注意到,未受伤膝关节患者(r = 0.37;P < 0.005)和对侧受伤膝关节患者(r = 0.33;P < 0.05)的股骨沟角(FSA)与PA之间存在统计学显著正相关(SSPCs)。未受伤和对侧受伤膝关节患者的性别和年龄组中,FSA与PA之间均存在SSPCs。与仅患侧PA的患者相比,患侧PFJ解剖结构发育异常(PA和TD)的患者,其未受伤膝关节FSA与PA之间的SSPCs更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9219/7996844/21fca704a083/medicina-57-00206-g001.jpg

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