Pathak Subodh Kumar, Sethi Manish, Salunke Abhijeet Ashok, Thivari Praveen, Gautam Rakesh Kumar, Anjum Rashid, Chawla Jasneet, Sharma Aryan
Department of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, M M Deemed to be University, Mullana, India.
Department of Orthopaedics, Phull Neuro Hospital, Patiala, India.
Indian J Orthop. 2021 May 13;55(5):1127-1134. doi: 10.1007/s43465-021-00418-1. eCollection 2021 Oct.
The purpose of this study was to evaluate the flexion-gap of the native knees in the normal population and to assess any gender-specific variations in the flexion gap of the knees.
A total of 50 normal asymptomatic volunteers with normal knee radiographs were selected for MRI of the knee. The left knee was scanned in an open MRI using a T1-weighted sequence. Imaging was performed in neutral, passive varus and valgus stress at 90° of knee flexion by placing custom-made blocks on a special board consecutively below the distal part of the leg.
The study population consisted of 26 males and 24 females with a mean age of 25.77 years. Under varus stress, the mean lateral flexion gap increased to 9.28 ± 1.53 mm and under valgus stress, the mean medial flexion gap increased to 2.75 ± 1.22 mm from neutral. The increase in the flexion gap on the lateral side was 5.28 ± 1.79 mm, which was significantly higher compared to that on the medial side. In gender-specific analysis, the mean lateral flexion gap was 10.21 mm in females and 8.46 mm in males under varus stress.
The findings of the study indicate that the lateral soft tissues are more lax compared to the medial soft tissue structures and this laxity is higher in females as compared to males. The study provides evidence of the existing physiological variations of these soft tissue structures resulting in a trapezoidal flexion gap in the native knees rather than the recommended rectangular gap.
本研究的目的是评估正常人群中天然膝关节的屈曲间隙，并评估膝关节屈曲间隙中是否存在任何性别特异性差异。
总共选择了50名膝关节X线片正常的无症状志愿者进行膝关节MRI检查。使用T1加权序列在开放式MRI中扫描左膝。通过在小腿远端下方的特殊板上连续放置定制的垫块，在膝关节屈曲90°时进行中立、被动内翻和外翻应力下的成像。
研究人群包括26名男性和24名女性，平均年龄为25.77岁。在内翻应力下，平均外侧屈曲间隙增加到9.28±1.53mm，在外翻应力下，平均内侧屈曲间隙从中立位增加到2.75±1.22mm。外侧屈曲间隙的增加为5.28±1.79mm，明显高于内侧。在性别特异性分析中，在内翻应力下，女性的平均外侧屈曲间隙为10.21mm，男性为8.46mm。
该研究结果表明，与内侧软组织结构相比，外侧软组织更松弛，并且女性的这种松弛程度高于男性。该研究提供了这些软组织结构存在生理差异的证据，这些差异导致天然膝关节中出现梯形屈曲间隙，而非推荐的矩形间隙。
