中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (3): 343-347.doi: 10.13418/j.issn.1001-165x.2016.03.022

• 临床研究 • 上一篇    下一篇

髌股关节形态学与髌骨软化症之间相关性研究

贾梦岩, 史占军, 肖军, 杨德盛, 黄志发   

  1. 南方医科大学南方医院关节与骨病外科,  广州   510515
  • 收稿日期:2015-11-24 出版日期:2016-05-25 发布日期:2016-06-17
  • 通讯作者: 史占军,主任医师,教授,博士生导师,E-mail:shizhanjun@yahoo.com;肖军,副主任医师,副教授,硕士生导师,E-mail:orthopaedxj@163.com
  • 作者简介:贾梦岩(1989-),男,河北石家庄人,在读硕士,研究方向:关节外科,E-mail:270097365@qq.com
  • 基金资助:

    国家自然科学基金青年基金(81101389)

Correlation between patellofemoral morphology and chondromalacia patellae

JIA Meng-yan,SHI Zhan-jun,XIAO Jun,YANG De-sheng,HUANG Zhi-fa   

  1. Department of Orthopaedic Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China
  • Received:2015-11-24 Online:2016-05-25 Published:2016-06-17

摘要:

目的 通过MRI进行髌股关节形态学参数测量,分析髌股关节形态与髌骨软化症之间的关联性。  方法 371例接受膝关节MRI检查的成人患者,诊断为髌骨软化症(chondromalacia patellae,CP)者纳入CP组(n=124),排除CP者纳入对照组(n=247),按性别分组计算CP患病率。通过MRI轴位片测量两组患者的外侧髌股角、滑车沟角、滑车沟深和外侧滑车倾斜角,根据软骨损伤的程度进一步将CP组分为CP(轻型)及CP(重型)两组。运用t检验对比CP组与对照组以及CP(轻型)组与CP(重型)组的各个参数组间差异。进一步运用χ2检验分析髌骨倾斜及滑车发育不良与CP的相关性。  结果 CP的患病率为33.42%(124/371),女性为49.35%(76/154),男性为22.12%(48/217),女性高于男性(P <0.01);CP组与对照组在外侧髌股角(P =0.00),滑车沟角(P =0.00),滑车沟深(P =0.00)及外侧滑车倾斜角(P =0.02)上均有显著性差异。CP(轻型)组与CP(重型)组在外侧髌股角、滑车沟角、滑车沟深、外侧滑车倾斜角上均未见统计学差异(均P >0.25)。无论是否考虑性别因素,髌骨倾斜与滑车发育不良均与CP存在显著相关性(P =0.00)。   结论 髌骨倾斜及滑车发育不良与CP显著相关,但与CP的严重程度无关。

关键词:  , 髌骨软化症, 髌股关节形态, 髌骨倾斜, 滑车发育不良

Abstract:

Objective To measure the morphological parameters of patellofemoral joint on MRI and analyze the etiological correlation between patellofemoral morphology and chondromalacia patellae (CP). Methods 371 adult patients undergoing MRI examination were enrolled and those diagnosed with CP were included in the CP group(n=124)and others in the control group(n=247). Prevalence rates of CP were recalculated and grouped according to gender. The lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle were measured in the MRI images on axial slices. The CP group was further divided into a mild and severe CP subgroup according to the degree of cartilage damage. The difference of patellofemoral morphology parameters among the CP group and control group, CP group (mild) and CP group (severe) were compared and the relationships among patella tilt, trochlear dysplasia and CP were further analyzed. Results The prevalence rate of CP was 33.42%, of which 49.35%was in women  and  22.12%was in men. Significant differences in the lateral patellofemoral angle (P=0.00), sulcus angle (P=0.00), trochlear depth (P=0.00) and lateral trochlear inclination angle (P=0.02)  could be found in the CP group and control group. However, there were no significant differences between patients in mild CP group and severe CP group in the lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle(all P>0.25). Considered gender or not, patellar tilt and trochlear dysplasia were significant correlated with chondromalacia patellae(P=0.00). Conclusion Patellar tilt and trochlear dysplasia are significantly correlated with CP but not the degree of CP.

Key words: Chondromalacia patellae, Patellofemoral morphology, Patellar tilt, Trochlear dysplasia