Chen Xiaobo, Ji Gang, Xu Chenyue, Wang Fei
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Orthop J Sports Med. 2023 Aug 9;11(8):23259671231181937. doi: 10.1177/23259671231181937. eCollection 2023 Aug.
Increased femoral anteversion (FA) is reportedly associated with patellar dislocation (PD) and trochlear dysplasia (TD), and the increase in FA may occur at different segments of the femur. In addition, TD is associated with dysplasia of the posterior femoral condyle. Among patients with PD, whether FA is greater with or without TD remains unclear.
To explore differences in FA and torsion distribution at different femoral sections among patients with PD and TD, patients with PD and no TD, and sex- and age-matched controls and to investigate the association between FA and distal femoral morphology.
Cross-sectional study; Level of evidence, 3.
This study involved 132 knees: 44 knees with PD and TD, 44 knees with PD but no TD, and 44 control knees. FA, proximal torsion (PT), middle torsion (MT), distal torsion (DT), and distal femoral morphology were measured. Differences were investigated by 1-way analysis of variance. Pearson correlation analysis was conducted to explore the association between FA and each parameter.
FA was significantly larger in the PD with TD group (25.4° ± 4.7°) than in the other groups (controls: 18.9° ± 5.6°; PD without TD: 19.9° ± 4.8°) ( < .01). DT was significantly larger in the PD with TD group (15.8° ± 2.9°) than in the other groups (controls: 9.0° ± 4.3°; PD without TD: 8.8° ± 3.9°) ( < .01). In all 3 groups, FA was strongly positively correlated with DT (control, PD without TD, and PD with TD, respectively: = 0.76, 0.80, and 0.88; < .01), strongly positively correlated with the posteromedial condylar length ( = 0.48, 0.48, and 0.70; < .01) and negatively correlated with the posterolateral condylar length ( = -0.30, -0.35, and -0.78, respectively; < .05).
The increased FA in knees with TD was due mainly to DT rather than PT or MT, which may provide a reference for choosing the optimal position for femoral derotation osteotomy.
据报道，股骨前倾角（FA）增大与髌骨脱位（PD）和滑车发育不良（TD）有关，且FA的增加可能发生在股骨的不同节段。此外，TD与股骨后髁发育不良有关。在PD患者中，伴或不伴TD时FA是否更大尚不清楚。
探讨PD和TD患者、PD但无TD患者以及性别和年龄匹配的对照组在不同股骨节段的FA和扭转分布差异，并研究FA与股骨远端形态之间的关系。
横断面研究；证据等级，3级。
本研究纳入132个膝关节：44个伴PD和TD的膝关节、44个有PD但无TD的膝关节以及44个对照膝关节。测量FA、近端扭转（PT）、中间扭转（MT）、远端扭转（DT）和股骨远端形态。通过单因素方差分析研究差异。进行Pearson相关分析以探讨FA与各参数之间的关系。
伴TD的PD组的FA（25.4°±4.7°）显著大于其他组（对照组：18.9°±5.6°；无TD的PD组：19.9°±4.8°）（P<0.01）。伴TD的PD组的DT（15.8°±2.9°）显著大于其他组（对照组：9.0°±4.3°；无TD的PD组：8.8°±3.9°）（P<0.01）。在所有3组中，FA与DT呈强正相关（对照组、无TD的PD组和伴TD的PD组，r分别为0.76、0.80和0.88；P<0.01），与后内侧髁长度呈强正相关（r分别为0.48、0.48和0.70；P<0.01），与后外侧髁长度呈负相关（r分别为-0.30、-0.35和-0.78；P<0.05）。
TD膝关节中FA增加主要归因于DT而非PT或MT，这可为选择股骨旋转截骨术的最佳位置提供参考。
