下胫腓联合远端形态分类与踝关节骨关节炎的相关性：一项回顾性研究。
Association between the distal tibiofibular syndesmosis morphology classification and ankle osteoarthritis: a retrospective study.
机构信息
School of Physical Education, Southwest Medical University, Luzhou, 646000, Sichuan Province, China.
School of Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China.
出版信息
J Orthop Surg Res. 2023 Aug 3;18(1):566. doi: 10.1186/s13018-023-03985-1.
BACKGROUND
Syndesmosis injury is proposed to contribute to ankle stability and osteoarthritis (OA). However, whether distal tibiofibular syndesmosis structure is closely related to ankle OA is unclear. We hypothesized that different DTS morphology classifications would affect the biomechanics properties in ankle OA. The study aimed to determine the association between the distal tibiofibular syndesmosis (DTS) morphological classification and ankle OA.
METHODS
This is a retrospective study examining imaging data of 147 patients (87 males and 60 females) with ankle OA. Magnetic resonance imaging was used to access the DTS morphological classification, according to measuring various parameters. Joint space narrowing and osteophytes were measured using ankle weight-bearing radiography. The classification and parameters were analyzed to determine the relationship between the syndesmosis classification and the abnormality of ankle OA.
RESULTS
Five morphological classifications of the DTS, including Chevron (19.6%), Widow's peak (16.2%), Flat (22.3%), Trapezoid (32.0%), and Crescent (19.6%), were shown. There were statistical differences between DTS classification and tibial angle surface angle (TAS) (P = .009) and talar tilt angle (TTA) (P = .014). The TAS (degree) of the Crescent (86.47 ± 3.21) was less than Chevron (88.75 ± 2.72) (P = .006), Widow's peak (89.26 ± 3.15) (P = .001), Flat (88.83 ± 3.62) (P = .003) and Trapezoid (88.11 ± 2.62) (P = .041), respectively. The TTA (degree) of Crescent (86.83 ± 5.30) was less than Chevron (89.28 ± 2.46) and Widow's peak (89.82 ± 3.41). The men were greater than women for TAS (P = .008) and angle (P = .003), which are consistent with osteophyte (P = .019) and the modified Kellgren-Lawrence grades (P = .041) between gender.
CONCLUSIONS
DTS morphological classification might affect the biomechanics properties in TAS and TTA in ankle OA. In clinical practice, surgeons should pay attention to the effects of DTS on ankle OA.
LEVEL OF EVIDENCE
Level III, retrospective study.
背景
下胫腓联合损伤被认为有助于踝关节稳定性和骨关节炎（OA）。然而，下胫腓联合的远端结构是否与踝关节 OA 密切相关尚不清楚。我们假设不同的 DTS 形态分类会影响踝关节 OA 的生物力学特性。本研究旨在确定下胫腓联合（DTS）形态分类与踝关节 OA 之间的关系。
方法
这是一项回顾性研究，共纳入 147 例（87 例男性和 60 例女性）踝关节 OA 患者的影像学资料。使用磁共振成像（MRI）根据测量的各种参数来评估 DTS 形态分类。采用踝关节负重位 X 线片测量关节间隙变窄和骨赘。对分类和参数进行分析，以确定 DTS 分类与踝关节 OA 异常之间的关系。
结果
DTS 存在 5 种形态学分类，包括 Chevron（19.6%）、Widow's peak（16.2%）、Flat（22.3%）、Trapezoid（32.0%）和 Crescent（19.6%）。DTS 分类与胫骨角面角（TAS）（P = .009）和距骨倾斜角（TTA）（P = .014）存在统计学差异。Crescent（86.47±3.21）的 TAS（度）小于 Chevron（88.75±2.72）（P = .006）、Widow's peak（89.26±3.15）（P = .001）、Flat（88.83±3.62）（P = .003）和 Trapezoid（88.11±2.62）（P = .041）。Crescent（86.83±5.30）的 TTA（度）小于 Chevron（89.28±2.46）和 Widow's peak（89.82±3.41）。男性的 TAS（P = .008）和角度（P = .003）大于女性，这与性别间的骨赘（P = .019）和改良 Kellgren-Lawrence 分级（P = .041）一致。
结论
DTS 形态分类可能影响踝关节 OA 中 TAS 和 TTA 的生物力学特性。在临床实践中，外科医生应注意 DTS 对踝关节 OA 的影响。
证据水平
III 级，回顾性研究。
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