通过计算机断层扫描测量时，胫骨结节扭转与髌骨高度相关。
Tibial tubercle torsion is associated with patellar height when measured by computed tomography.
作者信息
Giusto Joseph D, Kaarre Janina, Kim Yongji, An Jae-Sung, LiArno Sally, Ahmad Faizan, Ollivier Matthieu
机构信息
Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA.
Department of Orthopaedics, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
出版信息
J Exp Orthop. 2025 May 6;12(2):e70258. doi: 10.1002/jeo2.70258. eCollection 2025 Apr.
PURPOSE
To establish an average tibial tubercle (TT) torsion angle from computed tomography (CT) scans of patients without known patellofemoral instability and investigate whether TT torsion angles would differ based on demographics, tibial tubercle-trochlear groove (TT-TG) distance and patellar height.
METHODS
The Stryker Orthopaedics Modeling and Analytics (SOMA) database was queried for patients with CT scans and available measures related to patella and TT position. The mean TT torsion angle was compared in patients with an increased and normal TT-TG distance (≥20 vs. <20 mm) and patellar height (Insall-Salvati [IS] index ≥1.3 vs. <1.3). Measurements of sulcus angle, patellar inclination angle, congruence angle, trochlear groove depth and long limb axis alignment were assessed.
RESULTS
A total of 886 knees from 499 patients within the SOMA database were included, with a mean age of 59.4 ± 16.5 years and 238 (48%) females. The mean TT torsion angle for all patients was 24.7 ± 5.2°. Females had a significantly higher mean IS index (1.24 vs. 1.18), TT-TG distance (13.8 mm vs. 11.8 mm) and TT torsion angle (25.5° vs. 24.0°) compared to males. The mean TT torsion angle for patients with a TT-TG distance ≥20 mm and <20 mm was 24.7° in both groups ( = n.s.). There was a significantly greater TT torsion angle in patients with an IS index ≥1.3 (26.6°) compared to those with an IS index <1.3 (24.0°) ( < 0.001). A weak and positive correlation was found between TT torsion angle and IS index ( = 0.242, < 0.001), but not with other measurements.
CONCLUSION
The mean TT torsion angle for patients without known patellofemoral instability was 24.7° and increased TT torsion angles were associated with increased patellar height. An association between TT torsion and TT-TG was not found. Findings of the current study describe the relationship between morphologic assessments of the patellofemoral joint using CT.
LEVEL OF EVIDENCE
Level IV, cohort study.
目的
通过对无已知髌股关节不稳定患者的计算机断层扫描（CT）建立平均胫骨结节（TT）扭转角，并研究TT扭转角是否会因人口统计学特征、胫骨结节-滑车沟（TT-TG）距离和髌骨高度而有所不同。
方法
查询史赛克骨科建模与分析（SOMA）数据库中进行过CT扫描且有与髌骨和TT位置相关可用测量值的患者。比较TT-TG距离增加和正常（≥20 vs. <20 mm）以及髌骨高度（Insall-Salvati [IS]指数≥1.3 vs. <1.3）患者的平均TT扭转角。评估沟角、髌骨倾斜角、适合角、滑车沟深度和长肢轴对线的测量值。
结果
SOMA数据库中纳入了499例患者的886个膝关节，平均年龄为59.4±16.5岁，女性238例（48%）。所有患者的平均TT扭转角为24.7±5.2°。与男性相比，女性的平均IS指数（1.24 vs. 1.18）、TT-TG距离（13.8 mm vs. 11.8 mm）和TT扭转角（25.5° vs. 24.0°）显著更高。TT-TG距离≥20 mm和<20 mm的患者组平均TT扭转角均为24.7°（P = 无显著差异）。IS指数≥1.3的患者（26.6°）的TT扭转角显著大于IS指数<1.3的患者（24.0°）（P < 0.001）。发现TT扭转角与IS指数之间存在弱正相关（r = 0.242，P < 0.001），但与其他测量值无关。
结论
无已知髌股关节不稳定患者的平均TT扭转角为24.7°，TT扭转角增加与髌骨高度增加相关。未发现TT扭转与TT-TG之间存在关联。本研究结果描述了使用CT对髌股关节进行形态学评估之间的关系。
证据水平
IV级，队列研究。
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