Çeliksöz Aytek Hüseyin, Alpay Yakup, Ezici Atakan, Yozgatlı Tahir Koray, Daştan Ali Engin, Vahabi Arman, Kocaoglu Baris
Koç University Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
Medical Park Maltepe Hospital, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
Orthop J Sports Med. 2025 Jul 14;13(7):23259671251353754. doi: 10.1177/23259671251353754. eCollection 2025 Jul.
Recurrent patellar dislocation (RPD) is a common condition, particularly in adolescents, with several anatomic factors, such as increased femoral torsion, contributing to its development. Accurate assessment of these factors is essential for effective diagnosis and treatment planning.
To examine the correlation between femoral torsion and RPD and to measure the level of torsion using magnetic resonance imaging (MRI).
Cross-sectional study; Level of evidence, 3.
A total of 212 individuals were initially screened. Of these, 22 patients (31 femurs) who satisfied the inclusion criteria were included in the final analysis as the study group. The control group consisted of 28 patients (28 femurs) without a history of RPD. MRI measurements were conducted across 3 distinct axial sections. Supratrochanteric torsion (STT) value, infratrochanteric torsion (ITT) value, and femoral anteversion were analyzed utilizing T2-weighted turbo spin-echo sections. The distribution of the variables was determined using the Kolmogorov-Smirnov test. The independent-samples test and chi-square test were used to analyze quantitative independent data. The Fisher exact test was used when the conditions appropriate for the chi-square test were not met.
The mean femoral anteversion was higher in the patellar dislocation group, with a statistically significant difference (20.1 ± 3.8 vs 11.5 ± 1.8; = .0001). The mean STT was significantly greater in the patellar dislocation group (41.3 ± 7.6 vs 35.2 ± 3.1; = .0002). The mean ITT values were comparable between the groups (22.7 ± 2.8 vs 23.7 ± 2.3; = .14).
Our results indicate that increased femoral anteversion in RPD originates from the supratrochanteric region of the femur. Future large-scale studies, specifically focusing on the relationship between femoral anatomic variables and patellar instability, could yield significant insights into this matter.
复发性髌骨脱位（RPD）是一种常见病症，尤其在青少年中，有多种解剖学因素，如股骨扭转增加，会促使其发生。准确评估这些因素对于有效诊断和治疗规划至关重要。
研究股骨扭转与RPD之间的相关性，并使用磁共振成像（MRI）测量扭转程度。
横断面研究；证据等级，3级。
最初共筛选了212名个体。其中，22例符合纳入标准的患者（31个股骨）被纳入最终分析作为研究组。对照组由28例无RPD病史的患者（28个股骨）组成。在3个不同的轴向层面进行MRI测量。利用T2加权快速自旋回波序列分析转子上扭转（STT）值、转子下扭转（ITT）值和股骨前倾。使用Kolmogorov-Smirnov检验确定变量的分布。采用独立样本检验和卡方检验分析定量独立数据。当不满足卡方检验的条件时，使用Fisher精确检验。
髌骨脱位组的平均股骨前倾较高，差异有统计学意义（20.1±3.8对11.5±1.8；P = 0.0001）。髌骨脱位组的平均STT明显更大（41.3±7.6对35.2±3.1；P = 0.0002）。两组之间的平均ITT值相当（22.7±2.8对23.7±2.3；P = 0.14）。
我们的结果表明，RPD中股骨前倾增加源于股骨转子上区域。未来专门关注股骨解剖变量与髌骨不稳定之间关系的大规模研究，可能会对这一问题产生重要见解。
