MRI矢状位和轴位测量前交叉韧带断裂与髌股关节的稳定性  

Anterior cruciate ligament rupture and patellofemoral joint stability before sagittal and axial measurement using MRI

作　　者：李杰[1,2] 张海涛[1] 陈锦伦[2] 叶鹏程 张华 周本根[2] 赵长青 孙友强[2] 陈建发 向孝兵[2] 曾意荣 Li Jie;Zhang Haitao;Chen Jinlun;Ye Pengcheng;Zhang Hua;Zhou Bengen;Zhao Changqing;Sun Youqiang;Chen Jianfa;XiangXiaobing;Zeng Yirong(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Department of Orthopedics,First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学,广东省广州市510405 [2]广州中医药大学第一附属医院骨科,广东省广州市510405

出　　处：《中国组织工程研究》2022年第6期969-972,共4页Chinese Journal of Tissue Engineering Research

基　　金：广东省中医药管理局科研基金(20171088),项目负责人:李杰。

摘　　要：背景:前交叉韧带断裂是造成膝关节失稳的重要原因之一,关于前交叉韧带断裂后与髌股关节稳定性的相关研究目前报道较少。目的:探讨前交叉韧带断裂与髌股关节稳定性的关系。方法:回顾性病例-对照研究。设置研究组为经膝关节镜检证实前交叉韧带完全断裂患者65例;正常组为参加体检的健康人群65例。分别在膝关节MRI矢状位和轴位测量两组髌股关节不稳的相关参数,比较两组之间的差异。研究方案的实施符合广州中医药大学第一附属医院的相关伦理要求,受试者及家属对受试过程完全知情同意。结果与结论:(1)研究组的胫骨结节-股骨滑车间距值显著小于正常组(P<0.05),髌骨外倾斜角显著大于正常组(P<0.05);(2)2组髌骨基线值比较,差异无显著性意义(P>0.05);研究组滑车基线值及髌骨滑车指数均显著小于正常组(P<0.05);(3)结果说明,前交叉韧带完全断裂后可致胫骨结节-股骨滑车间距减小、髌骨外倾斜角增大以及高位髌骨,导致髌股关节稳定性发生改变,可能是髌股关节炎产生的潜在危险因素。BACKGROUND:Anterior cruciate ligament rupture is one of the important causes of knee instability.There are few reports on the relationship between anterior cruciate ligament rupture and patellofemoral joint stability.OBJECTIVE:To discuss the relationship between anterior cruciate ligament rupture and patellofemoral stability.METHODS:This was a retrospective case-control study.A total of 65 cases of complete rupture of the anterior cruciate ligament confirmed by knee arthroscopy were set as the study group;65 healthy persons participating in physical examination were set as the normal group.The parameters related to patellofemoral joint instability were measured in sagittal and axial MRI of the knee and compared between the two groups.The implementation of the study scheme was in accordance with the relevant ethical requirements of the First Affiliated Hospital of Guangzhou University of Chinese Medicine,and the subjects and their families gave full informed consent to the study process.RESULTS AND CONCLUSION:(1)The results tibial tubercle-femoral block spacing was shorter in the study group than that in the normal group(P<0.05).Patellar tilt angle was significantly larger in the study group than that in the normal group(P<0.05).(2)There was no statistically significant difference in baseline patella between the two groups(P>0.05).The baseline value of trochlear and patella trochlear index was significantly lower in the study group than those in the normal group(P<0.05).(3)It is concluded that completely anterior cruciate ligament rupture can decrease tibial tubercle-trochlear groove distance,increase the patellar tilt angle,rise patellar alta,and change the stability of the patellofemoral joint.It may be the potential risk factor for the patellofemoral arthritis.

关 键 词：前交叉韧带断裂 髌股关节 稳定性 髌骨外倾斜角 高位髌骨 胫骨结节-股骨滑车间距 

分 类 号：R459.9[医药卫生—治疗学] R496[医药卫生—临床医学]