Pediatric Orthopedics, Deformity Reconstruction and Foot Surgery, Muenster University Hospital, Germany.
Danish Pediatric Orthopedic Research, Aarhus University Hospital, Denmark; Children's Orthopaedics and Reconstruction, Aarhus University Hospital, Denmark.
Acta Orthop. 2023 Jul 31;94:393-398. doi: 10.2340/17453674.2023.15336.
For correction of leg-length discrepancy or angular deformity of the lower limb in skeletally immature patients temporary or permanent (hemi-)epiphysiodesis can be employed. These are reliable treatments with few complications. Recently, radiographic analysis of treatment-related alterations of the central knee anatomy gained interest among pediatric orthopedic surgeons. To date the comparison and adequate interpretation of potential changes of the central knee anatomy is limited due to the lack of defined standardized radiographic references. We aimed to establish new reference values of the central knee anatomy.
A retrospective analysis of calibrated longstanding anteroposterior radiographs of 254 skeletally immature patients with a chronological age ranging from 8 to 16 years was conducted. The following radiographic parameters were assessed: (1) femoral floor angle, (2) tibial roof angle, (3) width at femoral physis, and (4) femoral notch-intercondylar distance.
All observed radiographic parameters were normally distributed with a mean age of 12.4 years (standard deviation [SD] 2, 95% confidence interval [CI] 12.2-12.6). Mean femoral floor angle was 142° (SD 6, CI 141.8-142.9), mean tibial roof angle was 144° (SD 5, CI 143.7-144.1), mean width at femoral physis was 73 mm (SD 6, CI 72.8-73.9), and mean femoral notch-intercondylar distance was 8 mm (SD 1, CI 7.5-7.7). The estimated intraclass correlation coefficient values were excellent for all measurements.
This study provides new radiographic reference values of the central knee anatomy for children between 8 and 16 years and we suggest considering values within the range of 2 SD as the physiological range.
对于骨骼未成熟患者下肢的长度差异或角度畸形的矫正，可以采用临时或永久性（半）骺板切除术。这些都是可靠的治疗方法，并发症很少。最近，儿科骨科医生对治疗相关的中央膝关节解剖结构变化的放射学分析产生了兴趣。迄今为止，由于缺乏定义明确的标准化放射学参考，对中央膝关节解剖结构的潜在变化的比较和充分解释受到限制。我们旨在建立中央膝关节解剖结构的新参考值。
对 254 名骨骼未成熟患者的长期前后位 X 线片进行了回顾性分析，这些患者的年龄从 8 岁到 16 岁不等。评估了以下 X 线参数：（1）股骨地板角，（2）胫骨屋顶角，（3）股骨骨骺宽度，和（4）股骨切迹-髁间距离。
所有观察到的 X 线参数均呈正态分布，平均年龄为 12.4 岁（标准差 [SD] 2，95%置信区间 [CI] 12.2-12.6）。平均股骨地板角为 142°（SD 6，CI 141.8-142.9），平均胫骨屋顶角为 144°（SD 5，CI 143.7-144.1），平均股骨骨骺宽度为 73mm（SD 6，CI 72.8-73.9），平均股骨切迹-髁间距离为 8mm（SD 1，CI 7.5-7.7）。所有测量的估计组内相关系数值均为优秀。
本研究为 8 至 16 岁儿童提供了中央膝关节解剖结构的新放射学参考值，我们建议将 2 SD 范围内的值视为生理范围。
