屈膝30°位CT扫描在髌股关节退变诊断中价值研究  

Value of CT Scanning in Degeneration of Patellar Femoral Joint of the Knee Joint at 30 Degrees Flexion

作　　者：张云海[1] 刘伟[1] 黄东辉[1] 林伟龙[1] ZhangYunhai;Liu Wei;Huang Donghui(Department of Orthopaedics,Huadong Hospital Affilicated to Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院骨科

出　　处：《实用骨科杂志》2019年第10期903-905,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨屈膝30°位CT扫描在髌股关节退变诊断中价值。方法将2012年1月至2014年6月间门诊收治的66例年龄40~59岁的髌股关节退变患者作为研究组,其中男14例,女52例,平均49.5岁。将门诊志愿者15人作为对照组,其中男4例,女11例,平均52.4岁。采用CT扫描屈膝20°和30°时的膝关节,测量髌骨外侧倾斜角(patellar lateral tilt angle,PLTA)和髌骨适配角(congruence angle,CA),与对照组人群结果比较。结果对照组人群在屈膝30°和20°时PLTA分别为(15.56±3.63)°和(17.34±4.33)°,PLTA相比差异无统计学意义,CA角>0°者分别为0例和5例;研究组在20°和30°扫描时PLTA分别为(12.83±5.12)°和(11.84±5.82)°,差异无统计学意义;屈膝20°和30°时CA角>0°者分别为51例和35例,所占比例分别为77%和53%,差异有统计学意义;PLTA<12°合并CA<0°者15例,PLTA为(9.47±3.61)°,PLTA<12°合并CA>0°者26例,PLTA为(6.78±4.93)°,PLTA>12°合并CA>0°者9例,PLTA为(15.89±4.26)°,PLTA>12°合并CA<0°者16例,PLTA为(17.87±2.73)°。结论对于年龄超过40岁人群,屈膝30°位CT扫描时的PLTA<12°预示髌股关节早期退变。Objective To study the value of CT scanning in 30°-flexed knee in diagnosis of patellar femoral joint degeneration.Methods From January 2012 to June 2014,66 patients with patellar femoral joint degeneration was collected in clinic and whose knee was scanned with CT at 20°and 30°flexion alternatively.The patellar lateral tilt angle(PLTA)and congruence angle(CA)was measured and compared.Fifteen voluteers without patellar femoral joint degeneration were collected as the control group whose knee was scanned and measured in the same way.The extent of pain in patients with patellar femoral joint disease was messured with visual analogue scale and its corraltion to PLTA and CA were analyzed.Results In control group,PLTA was(15.56±3.63)°in knee with 30 degree flexion and(17.34±4.33)°in knee with 20 degree flexion and there was no significant difference,CA of five persons was more than 0°with 20°flexation and none was more than 0°with 30°flexation.In patient group,PLTA was(11.84±5.82)°in 30°-flexed knee and(12.83±5.12)°in 20°-flexed knee and there was no significant difference between twogroup.CA of 51 persons was more than 0°in 20°-flexed knee and 35 was more than 0°in 30°-flexed knee,there was significant difference between two flexed angle for CA.There was significant difference in PLTA between two groups in 30°-flexed knee and in 20°-flexedknee.In patients group,there are four types of patellar femoral joint alignment,there are 15patients in type I whose PLTA<12°and CA<0°,and whose PLTA was(9.47±3.61)°;there are 26 patients in typeⅡwhose PLTA<12°and CA>0°,and whose PLTA was(6.78±4.93)°;there are 9 patients in typeⅢwhose PLTA>12°and CA>0°,and whose PLTA was(15.89±4.26)°;there are 16 patients in typeⅣwhose PLTA>12°and CA<0°,and whose PLTA was(17.87±2.73)°.Conclusion For patients older than 40 years,PLTA<12°has great value in diagnosing the patients with patellar femoral joint disease when measured in 30°-flexed knee.

关 键 词：髌股关节退变 屈膝30° 髌骨外侧倾斜角 髌骨匹配角 

分 类 号：R684[医药卫生—骨科学]