Abstract：
OBJECTIVE: This study aims to evaluate the application value of the tibial tubercle-trochlear groove distance (TT-TG distance) and tibial tubercle-midepicondyle distance (TT-ME distance) on CT images in patellofemoral instability, and further investigate the association between knee joint rotation angles and patellofemoral instability.
METHODS: We retrospectively analyzed CT image data of 59 patients with patellar dislocation (case group) and 39 normal knee joints (control group). We measured the TT-TG distance, TT-ME distance, and knee joint rotation angle (KJRA) of both groups, and the related indicators were analyzed using single-factor/multi-factor binary logistic stepwise regression analysis. Two senior radiologists were assigned to assess the inter-rater reliability. Interclass correlation coefficients (ICC) were calculated. Finally, we used receiver operating characteristic (ROC) curves to compare the diagnostic efficiency of these indicators in patellofemoral instability.
RESULTS: The results found significant differences between both groups in terms of TT-TG distance, TT-ME distance, KJRA angle, age, location, and gender (P < 0.05). In terms of inter-rater reliability, TT-TG distance and TT-ME distance ratios showed an excellent correlation between observers (TT-TG inter-rater ICC 0.969, TT-ME inter-rater ICC 0.955). Univariate logistic regression analysis indicated that except for location and gender, all other factors significantly affected patellofemoral instability (P < 0.05). The multivariate logistic regression analysis revealed that the TT-ME distance, age, and KJRA angle were statistically significant factors related to patellofemoral instability, with TT-ME distance being a risk factor for patellofemoral instability (OR value 1.572, P value 0.000). Moreover, the ROC curve analysis demonstrated that the diagnostic capability of the TT-ME distance for detecting patellofemoral instability was higher than that of the TT-TG distance and KJRA (AUC were 0.912, 0.851, and 0.735, respectively).
CONCLUSIONS: The TT-ME distance, age, and knee joint rotation angle are factors that affect patellofemoral instability. The TT-ME distance has better diagnostic efficiency for patellofemoral instability compared to the TT-TG distance and knee joint rotation angle.
METHODS: We retrospectively analyzed CT image data of 59 patients with patellar dislocation (case group) and 39 normal knee joints (control group). We measured the TT-TG distance, TT-ME distance, and knee joint rotation angle (KJRA) of both groups, and the related indicators were analyzed using single-factor/multi-factor binary logistic stepwise regression analysis. Two senior radiologists were assigned to assess the inter-rater reliability. Interclass correlation coefficients (ICC) were calculated. Finally, we used receiver operating characteristic (ROC) curves to compare the diagnostic efficiency of these indicators in patellofemoral instability.
RESULTS: The results found significant differences between both groups in terms of TT-TG distance, TT-ME distance, KJRA angle, age, location, and gender (P < 0.05). In terms of inter-rater reliability, TT-TG distance and TT-ME distance ratios showed an excellent correlation between observers (TT-TG inter-rater ICC 0.969, TT-ME inter-rater ICC 0.955). Univariate logistic regression analysis indicated that except for location and gender, all other factors significantly affected patellofemoral instability (P < 0.05). The multivariate logistic regression analysis revealed that the TT-ME distance, age, and KJRA angle were statistically significant factors related to patellofemoral instability, with TT-ME distance being a risk factor for patellofemoral instability (OR value 1.572, P value 0.000). Moreover, the ROC curve analysis demonstrated that the diagnostic capability of the TT-ME distance for detecting patellofemoral instability was higher than that of the TT-TG distance and KJRA (AUC were 0.912, 0.851, and 0.735, respectively).
CONCLUSIONS: The TT-ME distance, age, and knee joint rotation angle are factors that affect patellofemoral instability. The TT-ME distance has better diagnostic efficiency for patellofemoral instability compared to the TT-TG distance and knee joint rotation angle.
摘要：
目的：本研究旨在评估胫骨结节-滑车沟距离（TT-TG距离）和胫骨结节-滑车沟距离（TT-ME距离）在CT图像中的应用价值，并进一步研究膝关节旋转角度与髌股不稳定之间的关系。
方法：回顾性分析59例髌骨脱位患者（病例组）和39例正常膝关节（对照组）的CT影像资料。我们测量了TT-TG距离,TT-ME距离,两组膝关节旋转角度(KJRA),相关指标采用单因素/多因素二元Logistic逐步回归分析。指派了两名高级放射科医生来评估评估者之间的可靠性。计算类间相关系数(ICC)。最后,我们使用受试者工作特征(ROC)曲线比较了这些指标对髌股不稳定的诊断效能.
结果：结果发现两组之间在TT-TG距离方面存在显着差异，TT-ME距离,KJRA角度,年龄,location,性别(P<0.05)。就评估者间的可靠性而言，TT-TG距离和TT-ME距离比在观察者之间显示出极好的相关性（TT-TG评估者ICC0.969，TT-ME评估者ICC0.955）。单因素logistic回归分析显示,除地理位置和性别外,其他因素对髌股不稳定有显著影响(P<0.05)。多因素logistic回归分析显示，TT-ME距离，年龄,和KJRA角度是与髌股不稳定相关的有统计学意义的因素，TT-ME距离是髌股不稳定的危险因素(OR值1.572,P值0.000)。此外，ROC曲线分析显示,TT-ME距离对髌股不稳定性的诊断能力高于TT-TG距离和KJRA(AUC分别为0.912,0.851和0.735).
结论：TT-ME距离，年龄,膝关节旋转角度是影响髌股不稳定的因素。与TT-TG距离和膝关节旋转角度相比，TT-ME距离对髌股不稳定性具有更好的诊断效率。
方法：回顾性分析59例髌骨脱位患者（病例组）和39例正常膝关节（对照组）的CT影像资料。我们测量了TT-TG距离,TT-ME距离,两组膝关节旋转角度(KJRA),相关指标采用单因素/多因素二元Logistic逐步回归分析。指派了两名高级放射科医生来评估评估者之间的可靠性。计算类间相关系数(ICC)。最后,我们使用受试者工作特征(ROC)曲线比较了这些指标对髌股不稳定的诊断效能.
结果：结果发现两组之间在TT-TG距离方面存在显着差异，TT-ME距离,KJRA角度,年龄,location,性别(P<0.05)。就评估者间的可靠性而言，TT-TG距离和TT-ME距离比在观察者之间显示出极好的相关性（TT-TG评估者ICC0.969，TT-ME评估者ICC0.955）。单因素logistic回归分析显示,除地理位置和性别外,其他因素对髌股不稳定有显著影响(P<0.05)。多因素logistic回归分析显示，TT-ME距离，年龄,和KJRA角度是与髌股不稳定相关的有统计学意义的因素，TT-ME距离是髌股不稳定的危险因素(OR值1.572,P值0.000)。此外，ROC曲线分析显示,TT-ME距离对髌股不稳定性的诊断能力高于TT-TG距离和KJRA(AUC分别为0.912,0.851和0.735).
结论：TT-ME距离，年龄,膝关节旋转角度是影响髌股不稳定的因素。与TT-TG距离和膝关节旋转角度相比，TT-ME距离对髌股不稳定性具有更好的诊断效率。
