Abstract：
OBJECTIVE: The femoral trochlea axial orientation has been shown to be a better predictor of patellar dislocation than the femoral anteversion angle. However, no study has investigated the importance of the femoral trochlea axial orientation in the surgical treatment of patellar dislocation. It is aimed to explore the pathological threshold of the femoral trochlea axial orientation and its guiding implications for surgical interventions in the study.
METHODS: Sixty-four patients with patellar dislocation and 64 controls were included for measurement of the femoral trochlea axial orientation. The ability to predict the patellar dislocation and the pathologic threshold of the femoral trochlea axial orientation were evaluated using the receiver operating characteristic curve. One hundred patients with medial patellofemoral ligament reconstruction and 25 patients with derotational distal femur osteotomy were divided into two groups based on the femoral trochlea axial orientation cut-off value and their postoperative knee functions, and patellar tilt angles were compared.
RESULTS: There were significant differences in the femoral trochlea axial orientation (60.8 ± 7.9 vs. 67.8 ± 4.6, p < 0.05) between patients with patellar dislocation and the normal population. The sensitivity and specificity of the femoral trochlea axial orientation were 0.641 and 0.813, respectively, at the femoral trochlea axial orientation smaller than 63.8°. Amongst patients having had isolated medial patellofemoral ligament reconstruction with decreased femoral trochlea axial orientation, knee function was poorer after surgery. The prognosis of patients with the femoral trochlea axial orientation correction in derotational distal femur osteotomy was better than that for patients without correction.
CONCLUSIONS: The femoral trochlea axial orientation had good predictive efficiency for patellar dislocation. Isolated medial patellofemoral ligament reconstruction is not sufficiently effective for patients with patellar dislocation and decreased femoral trochlea axial orientation. Patients with a decreased femoral trochlea axial orientation can have better surgical outcomes after correction by derotational distal femur osteotomy.
METHODS: Level III.
METHODS: Sixty-four patients with patellar dislocation and 64 controls were included for measurement of the femoral trochlea axial orientation. The ability to predict the patellar dislocation and the pathologic threshold of the femoral trochlea axial orientation were evaluated using the receiver operating characteristic curve. One hundred patients with medial patellofemoral ligament reconstruction and 25 patients with derotational distal femur osteotomy were divided into two groups based on the femoral trochlea axial orientation cut-off value and their postoperative knee functions, and patellar tilt angles were compared.
RESULTS: There were significant differences in the femoral trochlea axial orientation (60.8 ± 7.9 vs. 67.8 ± 4.6, p < 0.05) between patients with patellar dislocation and the normal population. The sensitivity and specificity of the femoral trochlea axial orientation were 0.641 and 0.813, respectively, at the femoral trochlea axial orientation smaller than 63.8°. Amongst patients having had isolated medial patellofemoral ligament reconstruction with decreased femoral trochlea axial orientation, knee function was poorer after surgery. The prognosis of patients with the femoral trochlea axial orientation correction in derotational distal femur osteotomy was better than that for patients without correction.
CONCLUSIONS: The femoral trochlea axial orientation had good predictive efficiency for patellar dislocation. Isolated medial patellofemoral ligament reconstruction is not sufficiently effective for patients with patellar dislocation and decreased femoral trochlea axial orientation. Patients with a decreased femoral trochlea axial orientation can have better surgical outcomes after correction by derotational distal femur osteotomy.
METHODS: Level III.
摘要：
目的：股骨滑车轴向取向已被证明比股骨前倾角更好地预测髌骨脱位。然而,尚无研究调查股骨滑车轴向定位在髌骨脱位手术治疗中的重要性。旨在探讨股骨滑车轴向定位的病理阈值及其对研究中手术干预的指导意义。
方法：纳入64例髌骨脱位患者和64例对照，以测量股骨滑车的轴向方向。使用接收器工作特征曲线评估了预测the骨脱位的能力和股骨滑车轴向定向的病理阈值。将100例内侧髌股韧带重建患者和25例股骨远端旋转截骨术患者根据股骨滑车轴向定位截断值及其术后膝关节功能分为两组，和髌骨倾斜角度进行比较。
结果：股骨滑车轴向方向存在显着差异（60.8±7.9vs.髌骨脱位患者与正常人群之间67.8±4.6，p<0.05）。股骨滑车轴向定位的敏感性和特异性分别为0.641和0.813,在股骨滑车轴向方向小于63.8°。在进行孤立的内侧髌股韧带重建并减少股骨滑车轴向定向的患者中，手术后膝关节功能较差。股骨远端旋转截骨术中股骨滑车轴向定向矫正的患者预后优于未矫正的患者。
结论：股骨滑车轴向定位对髌骨脱位具有良好的预测效能。孤立的内侧髌股韧带重建对于髌骨脱位和股骨滑车轴向取向降低的患者效果不佳。股骨滑车轴向方向降低的患者通过股骨远端截骨术进行矫正后，可以获得更好的手术效果。
方法：三级。
方法：纳入64例髌骨脱位患者和64例对照，以测量股骨滑车的轴向方向。使用接收器工作特征曲线评估了预测the骨脱位的能力和股骨滑车轴向定向的病理阈值。将100例内侧髌股韧带重建患者和25例股骨远端旋转截骨术患者根据股骨滑车轴向定位截断值及其术后膝关节功能分为两组，和髌骨倾斜角度进行比较。
结果：股骨滑车轴向方向存在显着差异（60.8±7.9vs.髌骨脱位患者与正常人群之间67.8±4.6，p<0.05）。股骨滑车轴向定位的敏感性和特异性分别为0.641和0.813,在股骨滑车轴向方向小于63.8°。在进行孤立的内侧髌股韧带重建并减少股骨滑车轴向定向的患者中，手术后膝关节功能较差。股骨远端旋转截骨术中股骨滑车轴向定向矫正的患者预后优于未矫正的患者。
结论：股骨滑车轴向定位对髌骨脱位具有良好的预测效能。孤立的内侧髌股韧带重建对于髌骨脱位和股骨滑车轴向取向降低的患者效果不佳。股骨滑车轴向方向降低的患者通过股骨远端截骨术进行矫正后，可以获得更好的手术效果。
方法：三级。
