髌股关节病中髌骨外侧骨赘形成的相关危险因素分析  

Risk Factors of Lateral Patellar Osteophyte Formation in Patellofemoral Arthropathy

作　　者：曹健夫 蔡雨琦 刘颖[3] 崔国庆[4] 杨渝平[4] Cao Jianfu;Cai Yuqi;Liu Ying;Cui Guoqing;Yang Yuping(Fuxing Hospital,Capital Medical University,Beijing 100038,China;The Sixth Clinical Medical School of Capital Medical University,Beijing 100069,China;Department of Radiology,Peking University Third Hospital,Beijing 100191,China;Department of Sports Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]首都医科大学附属复兴医院,北京100038 [2]首都医科大学第六临床医学院,北京100069 [3]北京大学第三医院放射科,北京100191 [4]北京大学第三医院运动医学科,北京100191

出　　处：《实用骨科杂志》2023年第7期588-591,608,共5页Journal of Practical Orthopaedics

摘　　要：目的分析髌股关节病中髌骨外侧缘骨赘形成的相关危险因素。方法回顾分析2015年12月至2019年12月由北京大学第三医院同一医生手术的连续75例符合纳入和排除标准的髌股关节病患者的临床资料。其中男21例,女54例;平均身体质量指数(body mass index,BMI)为(25.3±2.9)kg/m^(2);年龄28~78岁,平均(55.1±12.2)岁。运用独立样本t检验、χ^(2)检验和秩和检验对相关危险因素进行单因素分析,相关危险因素包括年龄、病程、性别、BMI、髌骨软骨损伤等级、内外侧间室损伤等级和髌骨外侧倾斜角(patellar tilting angle,PTA)。本研究运用Outer-bridge分级评估髌骨软骨损伤等级和内外侧间室损伤等级,运用PTA评估髌骨排列异常。本研究将单因素分析结果P≤0.1的相关危险因素纳入多因素分析,运用Logistic回归进行多因素分析。结果单因素分析中,有骨赘组和无骨赘组相比,年龄(t=-2.026,P=0.046)、髌骨软骨损伤(Z=-2.651,P=0.008)和内侧间室损伤程度(Z=-2.110,P=0.035),差异具有统计学意义。多因素分析中,髌骨软骨损伤可能为髌骨外侧骨赘的独立危险因素(OR=2.093,95%CI=1.188~3.687,P=0.011)。结论髌骨外侧缘有骨赘者年龄更大,髌骨软骨损伤程度和内侧间室损伤程度更加严重。髌骨软骨损伤可能是髌骨外侧骨赘存在的独立危险因素。Objective To analyze the risk factors of osteophyte formation in patellofemoral joint disease.Methods The clinical data of 75 patients underwent patellofemoral arthropathy and met the inclusion and exclusion criteria were retrospectively analyzed.The patients were operated by the same doctor in Peking University Third Hospital from December 2015 to December 2019.There were 21 males and 54 females,with an average BMI of(25.3±2.9)and an average age of(55.1±12.2)years old ranging from 28 to 78 years old.Independent sample t test,chi-square test and rank sum test were used for single factor analysis of risk factors,including age,course of disease,sex,BMI,patellar cartilage injury grade,medial and lateral compartment injury grade and patellar tilting angle(PTA).In this study,patellar cartilage injury grade and medial or lateral compartment injury grade were evaluated by outer-bridge grade,and patellar alignment abnormality was evaluated by PTA.In this study,the related risk factors of P≤0.1 were included in the multivariate analysis,and logistic regression was used for multi-factor analysis.Results In univariate analysis,there were statistically significant differences in age(t=-2.026,P=0.046),patellar cartilage injury(Z=-2.651,P=0.008)and medial compartment injury degree(Z=-2.110,P=0.035)between the osteophyte group and the non-osteophyte group.In multivariate analysis,patellar cartilage injury was a possible independent risk factor for osteophytes on the lateral edge of the patella(OR=2.093,95%CI:1.188~3.687,P=0.011).Conclusion The patients with osteophytes at the lateral margin of patella are older,and the injury degree of patella cartilage and medial compartment is more serious.The injury of patella cartilage is a possible independent risk factor for osteophytes at the lateral margin of patella.

关 键 词：髌股关节病 骨赘 X线 危险因素 

分 类 号：R684[医药卫生—骨科学]