上胫腓关节面坡度与原发性膝关节骨关节炎的相关性研究  

The effects of upper tibiofibular joint surface slope on primary knee osteoarthritis

作　　者：郭利刚 郭庆功 王胜利 单晓威 Guo Ligang;Guo Qinggong;Wang Shengli;Shan Xiaowei(Department of Orthopedics,the First Affiliated Hospital of Henan University,Kaifeng,475000China.)

机构地区：[1]河南大学第一附属医院骨科,河南省开封市475000

出　　处：《中华解剖与临床杂志》2018年第5期384-387,共4页Chinese Journal of Anatomy and Clinics

摘　　要：目的 探讨上胫腓关节面坡度与原发性膝关节骨关节炎(KOA)发生及其Kellgren-Lawrence(K/L)分级的相关性.方法 纳入2016年1月—2017年6月河南大学第一附属医院骨科180例KOA患者临床资料(KOA组)进行回顾性分析,其中男50例、女130例,年龄60~75(66.3±8.36)岁,BMI为(25.3±3.96)kg/m2.选择该院同期180例排除KOA的健康体检者膝关节CT资料纳入非KOA组,其中男52例、女128例,年龄60~75(65.8±7.96)岁,BMI为(24.6±4.06)kg/m2.两组观察对象性别、年龄、BMI比较差异均无统计学意义(P值均>0.05).对KOA患者进行影像学K/L分级.在膝关节CT三维重建图像上分别测量两组观察对象的上胫腓关节面坡度.采用SPSS 21.0统计软件进行分析.结果 KOA组180例K/L分级分别为Ⅱ级52例、Ⅲ级60例、Ⅳ级68例.KOA组、非KOA组上胫腓关节面坡度在男性和女性分别为35.18° ±7.36°、29.39° ±8.37°和35.34° ±9.36°、30.97° ±10.89°,两组间同性别间比较差异均有统计学意义(P值均<0.05),组内不同性别间比较差异均无统计学意义(P值均>0.05).上胫腓关节面坡度和膝骨关节炎K/L分级经Spearman相关分析呈正相关(rs=0.166,P<0.05).结论 上胫腓关节面坡度偏大是KOA发病的高危因素,且与KOA严重程度相关.Objective To investigate the correlations between the slope of the upper tibiofibular joint and the incidence of primary knee osteoarthritis (KOA),and Kellgren-Lawrence (K/L)grade. Methods The clinical data of 180 patients with KOA in our hospital from January 2016 to June 2017 were selected as the KOA group.This retrospective review included 50 males and 130 females with an average age of 66.3±8.36 years (from 60 to 75 years old).Their BMI was (25.3±3.96)kg/m2.One hundred and eighty cases of non knee osteoarthritis (CT of knee joint for normal physical examination in our hospital) were selected as the no-KOA group including 52 males and 128 females with age of 60-75 (65.8±7.96) years,and their BMI is (24.6±4.06)kg/m2.There were no significant differences in gender,age and BMI between the two groups (all P values >0.05).The KOA patients were graded by imaging K/L classification.The slopes of the upper tibiofibular joint surface of the two groups were measured on the CT 3D reconstruction image of the knee,and were analyzed by SPSS 21.0 statistical software.Results In KOA group,there were 62 cases of K/L Ⅱ grade and 60 cases of K/L Ⅲ grade and 68 cases of K/L Ⅳ grade respectively.The slopes of the tibiofibular joint surface in KOA group was 35.18°±7.36° in males and 29.39°±8.37°in females respectively,while in non KOA group it was 30.18°±9.63°in males and 30.97°±10.89°in females respectively.There were significant difference between the two groups in males and in females (all P values <0.05).There were no significant differences in gender between the two groups (all P values >0.05).The correlation coefficient of Spearman regression between the gradient of the tibiofibular joint surface and the K/L grade was rs=0.166(P <0.05).Conclusions The upper slope of the tibiofibular joint is a high-risk factor for KOA,and which is associated with the severity of KOA.

关 键 词：骨关节炎 膝 上胫腓关节面坡度 CT三维重建 生物力学 

分 类 号：R684.3[医药卫生—骨科学]