腓骨头高度评价膝骨关节炎程度的意义  

Significance of fibular head height in evaluating extent of knee osteoarthritis

作　　者：李存祥 李德思 寇宁招 赵丽欣 张学波 降文豪 高明港 臧建成 LI Cun-xiang;LI De-si;KOU Ning-zhao;ZHAO Li-xin;ZHANG Xue-bo;JIANG Wen-hao;GAO Ming-gang;ZANG Jian-cheng(Department of Orthopedics,Ningjin County Hospital,Ningjin,Hebei 055550,China;Medical Department,The Third Hospital,Hebei Medical University,Shijiazhuang,Hebei 050051,China;Department of Hand and Foot Surgery,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]河北省宁晋县医院骨科,河北宁晋055550 [2]河北医科大学第三医院医务处,河北石家庄050051 [3]北京中医药大学第三附属医院手足外科,北京100029

出　　处：《中国矫形外科杂志》2025年第6期494-499,共6页Orthopedic Journal of China

基　　金：河北省邢台市科学技术局课题项目(编号:2020ZC235)。

摘　　要：[目的]探讨腓骨头高度(fibular head height,FHH)与膝关节骨关节炎(knee osteoarthritis,KOA)的发生与发展的相关性。[方法]本院2015年6月—2021年6月收治的116例患者纳入本研究,获取照片间隔时长平均(31.0±2.9)个月,对两个时间点资料进行比较,行两个时间点资料比较,对K-L分级与其他指标进行两两相关分析,以FHH值为因变量与其他因素进行多元线性逐步回归分析,探讨FHH与膝骨关节炎的相关性。[结果]与初次测量比,末次测量时年龄[(60.5±6.8)岁,(63.1±7.0)岁,P<0.001]、WOMAC评分[(34.0±6.2),(47.7±6.3),P<0.001]、膝关节K-L分级[例,I/II/III/IV,(0/89/22/5),(0/0/22/94),P<0.001]、FTA[(178.6±3.7)°,(181.8±5.3)°,P<0.001]、JLCA[(2.8±1.1)°,(4.4±1.7)°,P<0.001]均显著增加,HSS评分[(72.2±8.2),(56.5±7.8),P<0.001]、膝伸屈ROM[(109.7±7.8)°,(97.6±6.1)°,P<0.001]、MPTA[(86.5±1.8)°,(85.0±2.4)°,P<0.001]、AMTP[(8.7±4.2)mm,(5.2±4.9)mm,P<0.001]、FHH[(10.3±3.5)mm,(7.9±3.8)mm,P<0.001]、FHTPA[(7.5±2.2)°,(4.7±2.0)°,P<0.001]均显著减小。两两相关分析表明,K-L分级与年龄、WOMAC评分、FTA、MPTA、JLCA呈显著正相关(P<0.05),K-L分级与HSS评分、AMTP、ROM、FHH、FHTPA呈显著负相关(P<0.05)。多元逐步回归分析显示,FHH与JLCA、WOMAC呈显著负相关(P<0.05),与ROM、AMTP呈显著正相关(P<0.05)。[结论]本研究通过连续影像学测量直观证实了KOA患者病情进展与FHH有关,FHH可以作为KOA X线测量及评价指标。[Objective]To investigate the correlation between fibular head height(FHH)and the occurrence and development of knee osteoarthritis(KOA).[Methods]A total of 116 patients who visited our hospital from June 2015 to June 2021 were included in this study,with the average time interval of two X rays taken of(31.0±2.9)months.The data of the two time points were compared,and pairwise correlation analysis was conducted between K-L grading and other indicators.Using FHH value as dependent variable and other factors as independent variables,multiple linear stepwise regression analysis was performed to explore the correlation between FHH and severity of the knee osteoarthritis.[Results]The age[(60.5±6.8),(63.1±7.0),P<0.001],WOMAC score[(34.0±6.2),(47.7±6.3),P<0.001],K-L grade[I/II/III/IV,(0/89/22/5),(0/0/22/94),P<0.001],FTA[(178.6±3.7)°,(181.8±5.3)°,P<0.001],JLCA[(2.8±1.1)°,(4.4±1.7)°,P<0.001]were significantly increased,whereas the HSS score[(72.2±8.2),(56.5±7.8),P<0.001],the knee flexion-extension ROM[(109.7±7.8)°,(97.6±6.1)°,P<0.001],MPTA[(86.5±1.8)°,(85.0±2.4)°,P<0.001],AMTP[(8.7±4.2)mm,(5.2±4.9)mm,P<0.001],FHH[(10.3±3.5)mm,(7.9±3.8)mm,P<0.001],FHTPA[(7.5±2.2)°,(4.7±2.0)°,P<0.001]were significantly reduced at the last X ray check compared with those in initial X ray examination.Regarding to pairwise correlation analysis,the K-L grading was significantly positively correlated with age,WOMAC score,FTA,MPTA and JLCA(P<0.05),while was significantly negatively correlated with HSS score,AMTP,ROM,FHH and FHTPA(P<0.05).As results of multiple stepwise regression analysis,the FHH was significantly negatively correlated with JLCA and WOMAC(P<0.05),while significantly positively correlated with ROM and AMTP(P<0.05).[Conclusion]This study visually confirmed that the progression of KOA is related to FHH through continuous imaging measurements,proving that FHH might be influencing factor for the disease progression of KOA,and FHH can be used as an X-ray measurement and evaluation index for KOA.

关 键 词：膝关节骨关节炎 程度 股胫角 腓骨头高度 影像测量 

分 类 号：R684.3[医药卫生—骨科学]