Department of Orthopaedic Surgery, The First Central Hospital of Baoding, No. 320 Changcheng Street, Baoding, 071000, Hebei, People's Republic of China.
The First Department of Operating Room, The First Central Hospital of Baoding, No. 320 Changcheng Street, Baoding, 071000, Hebei, People's Republic of China.
J Orthop Surg Res. 2021 Oct 16;16(1):607. doi: 10.1186/s13018-021-02779-7.
The aim of this study was to evaluate patellar morphological changes following surgical correction of recurrent patellar dislocation in children.
A total of 35 immature children aged 5 to 10 years who suffered from bilateral recurrent patellar dislocation associated with abnormal patella morphology were enrolled in this study. The knees with the most frequent dislocations (treated with medial patellar retinacular plasty) were selected as the study group (SG), and those undergoing conservative treatment for the contralateral knee were selected as the control group (CG). Computed tomography (CT) scans were performed on all children preoperatively and at the last follow-up to evaluate morphological characteristics of the patella.
All the radiological parameters of the patella showed no significant difference between the two groups preoperatively. At the last follow-up for CT scans, no significant differences were found for the relative patellar width (SG, 54.61%; CG, 52.87%; P = 0.086) and the relative patellar thickness (SG, 26.07%; CG, 25.02%; P = 0.243). The radiological parameters including Wiberg angle (SG, 136.25°; CG, 122.65°; P < 0.001), modified Wiberg index (SG, 1.23; CG, 2.65; P < 0.001), and lateral patellar facet angle (SG, 23.35°; CG, 15.26°; P < 0.001) showed statistical differences between the two groups.
The patellar morphology can be improved by early surgical correction in children with recurrent patellar dislocation. Therefore, early intervention is of great importance for children diagnosed with recurrent patellar dislocation.
本研究旨在评估儿童复发性髌骨脱位手术后髌骨形态的变化。
共纳入 35 例 5 至 10 岁的双侧复发性髌骨脱位伴髌骨形态异常的未成熟儿童。选择髌骨最频繁脱位的膝关节（接受内侧髌骨支持带成形术治疗）作为研究组（SG），对另一侧膝关节进行保守治疗的作为对照组（CG）。所有儿童术前和末次随访时均行 CT 扫描，评估髌骨形态特征。
两组患者术前所有髌骨影像学参数均无显著差异。末次 CT 扫描随访时，相对髌骨宽度（SG 为 54.61%，CG 为 52.87%，P=0.086）和相对髌骨厚度（SG 为 26.07%，CG 为 25.02%，P=0.243）无显著差异。Wiberg 角（SG 为 136.25°，CG 为 122.65°，P<0.001）、改良 Wiberg 指数（SG 为 1.23，CG 为 2.65，P<0.001）和外侧髌骨面角（SG 为 23.35°，CG 为 15.26°，P<0.001）等影像学参数在两组间存在统计学差异。
儿童复发性髌骨脱位早期手术矫正可改善髌骨形态。因此，对复发性髌骨脱位患儿进行早期干预非常重要。
