Miao Mingyuan, Cai Haiqing, Zhang Li, Cai Haoqi
Department of Orthopedic Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Front Pediatr. 2023 Oct 25;11:1291739. doi: 10.3389/fped.2023.1291739. eCollection 2023.
Recurrent patellar dislocation (RPD) greatly affects active young individuals, necessitating the identification of risk factors for a better understanding of its cause. Previous research has connected RPD to lower limb alignment (LEA) abnormalities, such as increased femoral anteversion, tibial external rotation, knee valgus, and flexion. This study aims to use EOS technology to detect RPD-related LEA anomalies, enabling three-dimensional assessment under load conditions.
A total of 100 limbs (50 in the RPD group, 50 in the control group) were retrospectively analyzed. In the RPD group, we included limbs with recurrent patellar dislocation, characterized by dislocations occurs at least two times, while healthy limbs served as the control group. We used EOS technology, including 2D and 3D imaging, to measure and compare the following parameters between the two groups in a standing position: Femoral neck shaft angle (NSA), Mechanical femoral tibial angle (MFTA), Mechanical lateral distal femoral angle (mLDFA), Medial proximal tibial angle (MPTA), Anatomical femoral anteversion (AFA), External tibial torsion (ETT), and Femorotibial rotation (FTR).
The significant differences between the two groups were shown in NSA 3/2D, MFTA 3/2D, mLDFA 3/2D, MPTA 3D, AFA, FTR. No significant difference was shown in MPTA 2D, ETT between the RPD group and the control group. Further binary logistic regression analysis. Further binary logistic regression analysis was conducted on the risk factors affecting RPD mentioned above. and found four risk factors for binary logistic regression analysis: mLDFA (3D), AFA, NSA(3D), and FTR.
EOS imaging identified abnormal LEA parameters, including NSA, MFTA, mLDFA, MPTA, AFA, and FTR, as risk factors for RPD. Children with these risk factors should receive moderate knee joint protection.
复发性髌骨脱位（RPD）对活跃的年轻人影响极大，因此有必要确定风险因素，以便更好地了解其病因。先前的研究已将RPD与下肢对线（LEA）异常联系起来，如下肢前倾增加、胫骨外旋、膝外翻和屈曲。本研究旨在使用EOS技术检测与RPD相关的LEA异常，从而在负荷条件下进行三维评估。
回顾性分析了总共100条肢体（RPD组50条，对照组50条）。在RPD组中，纳入了复发性髌骨脱位的肢体，其特征为脱位至少发生两次，而健康肢体作为对照组。我们使用包括二维和三维成像的EOS技术，在站立位测量并比较两组之间的以下参数：股骨颈干角（NSA）、机械性股胫角（MFTA）、机械性股骨远端外侧角（mLDFA）、胫骨近端内侧角（MPTA）、解剖性股骨前倾（AFA）、胫骨外扭转（ETT）和股胫旋转（FTR）。
两组之间在NSA 3/2D, MFTA 3/2D, mLDFA 3/2D, MPTA 3D, AFA, FTR方面存在显著差异。RPD组和对照组在MPTA 2D、ETT方面无显著差异。对上述影响RPD的风险因素进行进一步二元逻辑回归分析。发现二元逻辑回归分析的四个风险因素：mLDFA（3D）、AFA、NSA(3D)和FTR。
EOS成像确定了包括NSA、MFTA、mLDFA、MPTA、AFA和FTR在内的LEA参数异常是RPD的风险因素。有这些风险因素的儿童应接受适度的膝关节保护。
