冠状位膝外侧股胫偏移的影像测量与相关分析  

Image measurement and correlation analysis of coronal lateral femorotibial deviation of the knee

作　　者：邓文芳 曾剑文 袁灵梅[2] 梁超轶 熊伟 郭灵 潘斌 魏文强 熊羽康 李勇[1] 曾志奎 DENG Wen-fang;ZENGJian-wen;YUAN Ling-mei;LIANG Chao-yi;XIONG Wei;GUO Ling;PAN Bin;WEI Wen-qiang;XIONG Yu-kang;LI Yong;ZENGZhi-kui(Jiangxi University of Traditional Chinese Medicine,Nanchang,Jiangxi 330004,China;Affiliated Hospital,Jiangxi University of Traditional Chinese Medicine,Nanchang,Jiangxi 330006,China;National Engineering Research Center of TCM Solid Preparation Manufacturing Technology,Jiangxi University of Traditional Chinese Medicine,Nanchang,Jiangxi 330004,China)

机构地区：[1]江西中医药大学,江西南昌330004 [2]江西中医药大学附属医院,江西南昌330006 [3]江西中医药大学中药固体制剂制造技术国家工程研究中心,江西南昌330004

出　　处：《中国矫形外科杂志》2025年第4期340-344,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:82460938,81960880);江西中医药大学科技创新团队项目(编号:CXTD22009)。

摘　　要：[目的]研究中国人群正常肢体存在冠状位膝外侧股胫偏移(lateral femorotibial deviation,LFTD)的发生率与程度,分析其与其他影像学参数的相关性。[方法]回顾性分析2020年10月—2023年10月本院华奕区域医学影像系统符合纳入标准的双下肢全长负重位X线片,测量LFTD、胫骨近端内侧角(mechanical medial proximal tibial angle,mMPTA)、髋-膝-踝角(hip knee ankle angle,HKA)、机械轴偏离(mechanical axis deviation,MAD)、外侧股骨远端机械角(mechanical lateral distal femoral angle,m LDFA)及关节线匹配角(joint line congruence angle,JLCA),评估该人群存在LFTD的程度及比例,比较男女两性之间测量结果差异,评估LFTD与其他影像学参数的相关性。[结果]本研究共纳入了387个正常单侧下肢全长的X线片,其中男性123例,女性264例。总体LFTD为(3.8±2.0)mm。本研究纳入387例正常的膝关节,91例(74.0%)男性膝关节和170例(64.4%)女性膝关节LFTD>3 mm,即膝关节存在体质性冠状位自然对位外侧偏移现象,仅6例男性膝关节与2例女性膝关节LFTD为负值。两性比较方面,男性组的年龄显著小于女性组[(53.3±19.4)岁vs(59.6±15.3)岁,P=0.001],男性组LFTD显著大于女性组[(4.2±1.9)mm vs(3.6±2.1)mm,P=0.005],但是,男性JLCA显著小于女性[(1.9±1.9)°vs(2.5±2.3)°,P=0.023]。两性之间HKA、mLDFA、m MPTA、MAD的差异均无统计学意义(P>0.05)。LFTD与其他影像指标的两两相关分析表明,所有影像测量指标均与LFTD相关,相关程度依次为mMPTA(r=-0.343,P<0.001),HKA(r=0.334,P<0.001)和MAD(r=0.323,P<0.001)。其他影像学参数相关程度较低:m LDFA(r=0.123,P=0.016)和JLCA(r=0.110,P=0.030)。[结论]中国人群正常膝关节大部分存在一定程度的冠状位膝外侧股胫偏移,其偏移程度与mMPTA、HKA及MAD存在一定的相关性。[Objective]To search the incidence and extent of lateral femorotibial deviation(LFTD)of the knee in normal lower limbs inChinese population,and analyze its correlation with other imaging parameters.[Methods]A retrospective study was conducted on the thefull length weight-bearing X-rays of both lower limbs taken in our hospital with Huayi Regional Medical imaging System from October2020 to October 2023.The LFTD,mechanical medial proximal tibial angle(mMPTA),hip knee ankle angle(HKA),mechanical axis devia-tion(MAD),mechanical lateral distal femoral angle(mLDFA)and joint line congruence angle(JLCA)were measured and compared be-tween the male and female genders.The incidence and extent of LFTD were assayed in this population,additionally,the correlation be-tween LFTD and other imaging parameters was analyzed.[Results]A total of 387 full-length X-rays of normal unilateral lower limbs wereincluded in the study,involving 123 males and 264 females.The overall LFTD was of(3.8±2.0)mm.According to Nayak's criteria,amongthe 387 normal knees included in this study,91(74.0%)male knees and 170(64.4%)female knees had LFTD>3 mm,which meant theknee had constitutional coronal lateral alignment deviation,and only 6 male knees and 2 female knees had negative LFTD.In terms of gen-der comparison,the male was significantly yonger than the female[(53.3±19.4)years vs(59.6±15.3)years,P=0.001],the male had signifi-cantly greater LFTD than the female[(4.2±1.9)mm vs(3.6±2.1)mm,P=0.005],and the male proved significantly less JLCA than the female[(1.9±1.9)°vs(2.5±2.3)°,P=0.023].However,there were no significant differences regarding to HKA,mLDFA,mMPTA and MAD betweenmen and women(P>0.05).As results of pairwise correlation analysis between LFTD and other image parameters,all the other image mea-surements were correlated with LFTD,and the correlation extent was ranked as mMPTA(r=-0.343,P<0.001).HKA(r=0.334,P<0.001),and MAD(r=0.323,P<0.001),mLDFA(r=0.123,P=0.016)and JLCA(r=0.110,P=0.030).[Conclusion]Most of the normal knee in Chi-nese pop

关 键 词：膝关节冠状位自然对位 膝外侧股胫偏移 影像测量 胫骨平台骨折脱位 

分 类 号：R68[医药卫生—骨科学]