对于身材较高的患者，应考虑更高的胫骨结节-滑车沟距离增大的病理阈值。
Higher pathologic threshold of increased tibial tuberosity-trochlear groove distance should be considered for taller patients.
机构信息
Sports Medicine Department, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, No. 49 North Garden Road, Haidian, Beijing, 100191, People's Republic of China.
Peking University Institute of Sports Medicine, No. 49 North Garden Road, Haidian, Beijing, 100191, People's Republic of China.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2022 Nov;30(11):3760-3766. doi: 10.1007/s00167-022-06992-7. Epub 2022 May 17.
PURPOSE
The aim of this study was to evaluate the correlation between tibial tuberosity-trochlear groove distance (TT-TG) and body height or knee size, and to find height-related pathologic thresholds of increased TT-TG.
METHODS
One-hundred and fifty-three patients with recurrent patellar instability and 151 controls were included. The TT-TG was measured on axial computed tomography (CT) images. Femora width and tibial width were selected to represent knee size. The correlation of TT-TG and gender, body height, femora width, and tibial width was evaluated. The height-related pathologic threshold of increased TT-TG was produced according to Dejour's method. To combine TT-TG with body height and knee size, three new indexes were introduced, ratio of TT-TG to body height (RTH), ratio of TT-TG to femoral width (RTF), and ratio of TT-TG to tibial width (RTT). The ability to predict patellar instability was assessed by the receiver-operating characteristic (ROC) curve, odds ratios (ORs), sensitivity, and specificity.
RESULTS
In patients with patellar instability, TT-TG showed significantly correlation with patient height, femoral width, and tibial width respectively (range r = 0.266-0.283). This correlation was not found in the control group. The pathologic threshold of TT-TG was 18 mm in patients < 169 cm (53%), and the mean TT-TG was 21 mm in patients ≥ 169 cm (54%). There was significant difference in RTH, RTF, and RTT between the two groups. RTH, RTF and RTT have similar large area under the curve (AUC) with TT-TG.
CONCLUSIONS
TT-TG showed significant correlation with body height and knee size, respectively. The pathologic threshold of increased TT-TG was suggested to be 21 mm for patients [Formula: see text] 169 cm and 18 mm for patients [Formula: see text] 169 cm. Body height-related pathologic threshold provided a supplement for indications of tibial tuberosity medialization.
LEVEL OF EVIDENCE
IV.
目的
本研究旨在评估胫骨结节-滑车沟（TT-TG）距离与身高或膝关节大小的相关性，并确定与身高相关的 TT-TG 增大的病理性阈值。
方法
本研究纳入了 153 例复发性髌骨不稳定患者和 151 例对照组。在轴位 CT 图像上测量 TT-TG。选择股骨宽度和胫骨宽度来代表膝关节大小。评估 TT-TG 与性别、身高、股骨宽度和胫骨宽度的相关性。根据 Dejour 方法生成与身高相关的 TT-TG 增大的病理性阈值。为了将 TT-TG 与身高和膝关节大小结合起来，引入了三个新指标，即 TT-TG 与身高的比值（RTH）、TT-TG 与股骨宽度的比值（RTF）和 TT-TG 与胫骨宽度的比值（RTT）。通过受试者工作特征（ROC）曲线、比值比（OR）、灵敏度和特异性评估预测髌骨不稳定的能力。
结果
在髌骨不稳定患者中，TT-TG 与患者身高、股骨宽度和胫骨宽度分别呈显著相关（r 值范围为 0.266-0.283）。在对照组中未发现这种相关性。TT-TG 的病理性阈值在身高[Formula: see text]169cm 的患者中为 18mm（53%），而身高[Formula: see text]169cm 的患者中平均 TT-TG 为 21mm（54%）。两组之间 RTH、RTF 和 RTT 存在显著差异。RTH、RTF 和 RTT 与 TT-TG 具有相似的大曲线下面积（AUC）。
结论
TT-TG 与身高和膝关节大小均有显著相关性。建议对于身高[Formula: see text]169cm 的患者，TT-TG 增大的病理性阈值为 21mm，对于身高[Formula: see text]169cm 的患者，TT-TG 增大的病理性阈值为 18mm。与身高相关的病理性阈值为胫骨结节内移术的适应证提供了补充。
证据等级
IV 级。
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