膝关节旋转与髌骨不稳  

Knee rotation and patellar instability

作　　者：郭宗磊 王业华 刘广銮 Guo Zonglei;Wang Yehua;Liu Guangluan(Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China;Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学,江苏省徐州市221000 [2]徐州医科大学附属医院骨科,江苏省徐州市221000

出　　处：《中国组织工程研究》2023年第13期2099-2103,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:髌骨不稳与胫骨、股骨以及软组织的一系列解剖形态异常有关,髌骨不稳与膝关节旋转之间的关系尚未得到充分研究。目的:分析膝关节旋转角度对髌骨不稳的影响因素及两者之间的相关性。方法:纳入2018年9月至2021年11月徐州医科大学附属医院收治的膝关节骨性关节炎患者96例,收集患者膝关节三维CT与髌骨(merchant位)X射线片影像资料,通过测量胫骨近端旋转角度、股骨远端旋转角度、膝关节旋转角度、髌骨倾斜角度及髌骨外移距离等影像学参数,分析膝关节旋转与髌骨不稳之间的相关性。结果与结论:①Pearson相关性分析显示,膝关节旋转角度与髌骨倾斜角度(R=0.440,P<0.001)、髌骨外侧移位距离(R=0.453,P<0.001)中等相关,随着膝关节外旋转角度的增加,髌骨倾斜角度与髌骨外侧移位距离均增加;胫骨近端旋转角度与髌骨倾斜角度(R=0.578,P<0.001)和髌骨外侧移位距离(R=0.654,P<0.001)呈现出强相关,胫骨近端外旋转角度的增加,髌骨倾斜角度和髌骨外侧移位距离随之增加;股骨远端旋转与髌骨倾斜角度、髌骨外侧移位距离无相关性;②结果显示,在影像学表现中,髌骨外侧移位距离相比髌骨倾斜角度受膝关节旋转角度的影响小,胫骨近端旋转角度与膝关节旋转角度强相关,膝关节旋转的改变主要是受胫骨近端旋转影响,而股骨远端旋转与膝关节旋转无相关性。BACKGROUND:Patellar instability is associated with a series of anatomical abnormalities of tibia,femur and soft tissue.The relationship between patellar instability and knee rotation is not well established.OBJECTIVE:To analyze the influential factors of knee rotation on patellar instability and the correlation between them.METHODS:A total of 96 patients with knee osteoarthritis admitted to the Affiliated Hospital of Xuzhou Medical University from September 2018 to November 2021 were included.The image data of knee joint three-dimensional CT and patella(merchant position)X-ray film were collected.The correlation between knee rotation and patellar instability was analyzed by measuring the imaging parameters such as proximal tibia rotation,distal femur rotation,knee rotation,patellar tilt angle,and lateral patellar displacement distance.RESULTS AND CONCLUSION:(1)Pearson’s correlation analysis showed that knee rotation was moderately correlated with patellar tilt angle(R=0.440,P<0.001)and lateral patellar displacement distance(R=0.453,P<0.001).With the increase of knee external rotation,both patellar tilt angle and lateral patellar displacement distance increased.Proximal tibial rotation was strongly correlated with patellar tilt angle(R=0.578,P<0.001)and lateral patellar displacement distance(R=0.654,P<0.001).With the increased external rotation of proximal tibia,the patellar tilt angle and lateral patellar displacement distance increased.There was no correlation of distal femoral rotation with patellar tilt angle and lateral patellar displacement distance.(2)These findings indicate that in imaging findings,the lateral patellar displacement distance is less affected by knee rotation than the patellar tilt angle.The proximal tibial rotation was strongly correlated with knee rotation.The rotation of the knee joint was mainly affected by the proximal tibial rotation,while the distal femur rotation was not correlated with the rotation of the knee joint.

关 键 词：膝关节骨性关节炎 膝关节旋转 胫骨近端旋转 股骨远端旋转 髌骨不稳 髌骨倾斜角度 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学] R684