Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
J Orthop Surg Res. 2023 Feb 27;18(1):144. doi: 10.1186/s13018-023-03632-9.
Patellar instability (PI) usually combines with morphological abnormalities of femoral condyles that may affect the morphology of the intercondylar notch and anterior cruciate ligament (ACL), which are important in individualized ACL reconstruction. This study aimed to investigate the morphological characteristics of the intercondylar notch and ACL in patients with PI.
80 patients with PI and 160 age- and gender-matched controls from January 2014 to June 2022 were studied. Morphological measurements of the femoral condyles included intercondylar notch height, notch width, medial condylar width, lateral condylar width, bicondylar width, notch width index, notch angle, lateral femoral condyle ratio (LFCR), condyle flexion angle, and posterior tibial slope. Morphological measurements of the ACL included ACL length, inclination angle, and ACL size. The measurements were compared between PI and control groups, and between males and females in PI group. The independent samples t-test was performed to examine differences in continuous variables. The chi-square test was used for comparing categorical variables.
The intercondylar notch width, bicondylar width, notch width index, and notch angle were significantly smaller, while the LFCR was significantly larger in PI group than those of control group (p < 0.05). The ACL thickness (0.70 ± 0.16 cm vs 0.80 ± 0.21 cm, p = 0.023) and width (0.54 ± 0.14 cm vs 0.60 ± 0.13 cm, p = 0.029) were significantly smaller in PI group. The notch width was significantly smaller in female patients than males in PI group, but no significant difference was observed in the notch width index and notch angle (p > 0.05). No sex difference related to the morphology of the ACL was found.
The patient with PI had a stenotic intercondylar notch and a thin ACL. No significant sex difference in the intercondylar notch stenosis and ACL size was observed. The morphology of the intercondylar notch and ACL should be taken into consideration when planning individualized ACL reconstruction in the presence of PI.
髌骨不稳定（PI）通常与股骨髁的形态异常合并存在，这可能影响到髁间切迹和前交叉韧带（ACL）的形态，而这些在个体化 ACL 重建中非常重要。本研究旨在探讨 PI 患者髁间切迹和 ACL 的形态特征。
2014 年 1 月至 2022 年 6 月，共纳入 80 例 PI 患者和 160 例年龄和性别匹配的对照组。股骨髁的形态学测量包括髁间切迹高度、切迹宽度、内侧髁宽度、外侧髁宽度、双髁宽度、切迹宽度指数、切迹角、外侧股骨髁比（LFCR）、髁弯曲角和胫骨后倾角。ACL 的形态学测量包括 ACL 长度、倾斜角和 ACL 大小。比较 PI 组与对照组、PI 组男性与女性之间的测量值。采用独立样本 t 检验比较连续变量，采用卡方检验比较分类变量。
PI 组的髁间切迹宽度、双髁宽度、切迹宽度指数和切迹角明显小于对照组，而 LFCR 明显大于对照组（p<0.05）。PI 组的 ACL 厚度（0.70±0.16cm 比 0.80±0.21cm，p=0.023）和宽度（0.54±0.14cm 比 0.60±0.13cm，p=0.029）明显小于对照组。PI 组女性患者的髁间切迹宽度明显小于男性患者，但髁间切迹宽度指数和切迹角无显著差异（p>0.05）。未发现 ACL 形态与性别相关的差异。
PI 患者存在髁间切迹狭窄和 ACL 变细。在 PI 患者中，髁间切迹狭窄和 ACL 大小无明显性别差异。在进行个体化 ACL 重建时，应考虑髁间切迹和 ACL 的形态。
