在评估髌骨脱位方面，股骨前倾角度比TT-TG距离更具优势：一项回顾性队列研究。
Femoral anteversion angle is more advantageous than TT-TG distance in evaluating patellar dislocation: A retrospective cohort study.
作者信息
Chen Jiahui, Ma Xinlong, Ma Jianxiong, Zhang Shixiong, Wang Ying, Bai Haohao, Lu Bin, Wu Yanfei, Dai Jing
机构信息
Clinical College of Orthopedics, Tianjin Medical University, Tianjin, China.
Institute of Orthopedics, Tianjin Hospital, Tianjin, China.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2025 May;33(5):1721-1727. doi: 10.1002/ksa.12475. Epub 2024 Sep 18.
PURPOSE
The purpose of this study is to report the parameter characteristics of the femoral anteversion angle (FAA) and tibial tubercle-trochlear groove (TT-TG) distance in patients with patellar instability compared to healthy individuals and to evaluate their reliability in predicting patellar dislocation, providing potential indications for osteotomy.
METHODS
A retrospective collection of consecutive patients with patellar instability constituted the study group, while individuals without patellofemoral disorder served as the control group. Measurement of the FAA and TT-TG distance were conducted by lower extremity computed tomography scans and knees with true patellar dislocation were recorded. The diagnostic capability of the FAA and TT-TG distance was assessed using receiver operating characteristic curves and area under the curve (AUC), determining the pathological values by sensitivity and specificity.
RESULTS
The FAA (21.6 ± 9.0°) and TT-TG distance (20.1 ± 4.8 mm) in the study group were significantly greater than the control group (10.6 ± 7.9° and 15.6 ± 4.6 mm, respectively) (p < 0.001). The AUCs for patellar dislocation were 0.869 for FAA and 0.712 for TT-TG distance, with pathological cut-off values of 18.2° and 18.2 mm, respectively. The odds ratios for FAA and TT-TG distance were 1.185 and 1.125, respectively (p < 0.05).
CONCLUSIONS
Patients with patellar instability exhibited significantly greater FAA and TT-TG distance compared to healthy individuals. The FAA demonstrated superior predictive capability for patellar dislocation compared to the TT-TG distance. The FAA (>18.2°) measured by surgical transepicondylar axis and TT-TG distance (>18.2 mm) were the potential pathological thresholds. Additionally, an increase of 1° in FAA and 1 mm in TT-TG distance was associated with a 18.5% and 12.5% increased risk of patellar dislocation, respectively. Surgeons should be aware of the risk of patellar dislocation associated with rotational malalignment.
LEVEL OF EVIDENCE
Level III.
目的
本研究旨在报告与健康个体相比，髌骨不稳定患者的股骨前倾角（FAA）和胫骨结节-滑车沟（TT-TG）距离的参数特征，并评估它们在预测髌骨脱位方面的可靠性，为截骨术提供潜在指征。
方法
回顾性收集连续的髌骨不稳定患者组成研究组，无髌股关节疾病的个体作为对照组。通过下肢计算机断层扫描测量FAA和TT-TG距离，并记录真正髌骨脱位的膝关节情况。使用受试者工作特征曲线和曲线下面积（AUC）评估FAA和TT-TG距离的诊断能力，通过敏感性和特异性确定病理值。
结果
研究组的FAA（21.6±9.0°）和TT-TG距离（20.1±4.8mm）显著大于对照组（分别为10.6±7.9°和15.6±4.6mm）（p<0.001）。髌骨脱位的AUC，FAA为0.869，TT-TG距离为0.712，病理截断值分别为18.2°和18.2mm。FAA和TT-TG距离的优势比分别为1.185和1.125（p<0.05）。
结论
与健康个体相比，髌骨不稳定患者的FAA和TT-TG距离显著更大。与TT-TG距离相比，FAA对髌骨脱位表现出更好的预测能力。通过手术经髁轴测量的FAA（>18.2°）和TT-TG距离（>18.2mm）是潜在的病理阈值。此外，FAA每增加1°和TT-TG距离每增加1mm，髌骨脱位风险分别增加18.5%和12.5%。外科医生应意识到与旋转畸形相关的髌骨脱位风险。
证据水平
三级。
Zotero 插件