胫骨结节-后十字韧带距离定位髌股关节不稳患者胫骨结节位置的研究  

Value of tibial tuberosity-posterior cruciate ligament distance in the location of tibial tuberosity in patients with unstable patellofemoral joint

作　　者：郭瑞[1] 刘烁[2] 郭华[2] 吴广巍 郭栋 李坤[1] GUO Rui;LIU Shuo;GUO Hua;WU Guangwei;GUO Dong;LI Kun(Department of Orthopedics,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000;Medical Imaging Department,People's Hospital of Xinjiang Uygur Autonomous Region ,Urumqi830000,China)

机构地区：[1]新疆维吾尔自治区人民医院骨科中心关节与运动医学病区,乌鲁木齐830000 [2]新疆维吾尔自治区人民医院放射影像中心,乌鲁木齐830000

出　　处：《中华骨与关节外科杂志》2018年第9期688-692,共5页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:在髌股关节不稳患者中,胫骨结节-滑车沟距离(TT-TG)是指导临床行胫骨结节内移术的标准。然而,TT-TG距离没有准确的描述胫骨结节外移的程度。目的目的:研究定位髌股关节不稳患者胫骨结节位置的新方法—胫骨结节-后十字韧带距离(TT-PCL)的应用价值,并比较其和TT-TG距离的优缺点。方法方法:应用CT及MRI分析20例髌股关节不稳患者和20例无脱位患者的TT-TG值及TT-PCL值。将TT-PCL距离定义为胫骨结节中点与后十字韧带内侧边界之间的距离。比较观察组与对照组TT-PCL距离的统计学差异。结果结果:TT-TG距离和TT-PCL距离对诊断髌股关节不稳具有重要意义。对照组TT-TG距离(13.025±4.084) mm和观察组TT-TG距离(18.405±2.786) mm比较,差异有统计学意义(t=4.866,P<0.001)。对照组TT-PCL距离(17.965±3.727) mm和观察组TT-PCL距离(21.995±4.568) mm比较,差异有统计学意义(t=3.057,P<0.001)。结论结论:TT-TG距离和TT-PCL距离对诊断髌股关节不稳具有重要意义。通过MRI测量TT-PCL距离的方法,可用来评价胫骨结节相对外移程度,为临床上胫骨结节内移提供参考依据。Background:Tibial tubercle-trochlear groove (TT-TG)distance is considered as the criterion for tibial tubercle an- teromedial transfer in patients with patellofemoral instability.However,the TT-TG distance gives no information about the lo- cation of the malformation.Objective:To investigate the value of tibial tuberosity-posterior cruciate ligament (TT-PCL)distance in the treatment of patients with patellofemoral instability,and to compare the advantages and disadvantages of TT-PCL and TT-TG distances.Methods:CT and MRI were used to analyze the TT-TG and TT-PCL values of 20patients with patellofemoral instability and 20patients without dislocation.The tibial tuberosity-posterior crueiate ligament (TT-PCL)distance was defined as the distance between the midpoint of the tibial tuberosity and the medial border of the posterior cruciate ligament. The t-test was used to estimate the significant difference in TT-PCL distance between the observation group and the control group.Results:TT-TG and TT-PCL distances were both important for the diagnosis of patellofemoral instability.The rIT-TG distance in the control group (13.025±4.084)mm and in the observation group (18.405±2.786)mm had statistically significant difference(t=4.866,P<0.001).The TT-PCL distance in the control group (17.965_+3.727)mm and in the observation group (21.995±4.568)mm had statistically significant difference (t=-3.057,P<0.001).Conclusions:TT-TG and TT-PCL distances are both important for the diagnosis of patellofemoral instability.TT-PCL distance measured by MRI can be used to evaluate the relative degree of external migration of tibial tubercle which provides a reference for tibial tubercle internal migration.

关 键 词：胫骨结节一滑车沟距离 胫骨结节一后十字韧带距离 髌股关节不稳定 

分 类 号：R687.4[医药卫生—骨科学] R445.2[医药卫生—外科学] R816.8[医药卫生—临床医学]