■内侧髌股韧带(MPFL)重建是在低屈曲角度(0°-30°)下治疗髌股不稳定(PFI)患者的公认程序。关于MPFL手术在膝关节屈曲的前30°期间对髌股软骨接触面积(CCA)的影响知之甚少。
■本研究的目的是使用磁共振成像(MRI)研究MPFL重建对CCA的影响。我们假设PFI患者的CCA比健康膝盖患者低,并且在低膝关节屈曲过程中MPFL重建后CCA会增加。
■队列研究;证据水平,2.
■在一项前瞻性配对队列研究中,在MPFL重建前后测定13例低屈曲PFI患者的CCA,并将数据与13名健康志愿者(对照)的数据进行比较。MRI在膝关节0°时进行,15°,和30°的屈曲在一个定制设计的膝盖定位装置。要抑制运动伪影,通过附着在髌骨上的跟踪标记,使用莫尔相位跟踪系统进行运动矫正.在半自动软骨和骨分割和配准的基础上计算CCA。
■0°时的CCA(平均值±SD),15°,对照参与者的30°屈曲分别为1.38±0.62、1.91±0.98和3.68±0.92cm2。在PFI患者中,0°的CCA,15°,术前屈曲30°分别为0.77±0.49、1.26±0.60和2.89±0.89cm2,术后分别为1.65±0.55、1.97±0.68和3.52±0.57cm2。与对照组相比,PFI患者在所有3个屈曲角度的术前CCA显着降低(全部P≤0.045)。术后,屈曲0°时的CCA显着增加(P=.001),15°屈曲(P=.019)和30°屈曲(P=.026)。在任何屈曲角度下,PFI患者与对照组之间的CCA术后无显着差异。
■低屈曲髌骨不稳定患者在0°时髌股CCA显着降低,15°,和30°的屈曲。MPFL重建在所有角度都显着增加了接触面积。
UNASSIGNED: Medial patellofemoral ligament (MPFL) reconstruction is a well-established procedure for the treatment of patients with patellofemoral instability (PFI) at low flexion angles (0°-30°). Little is known about the effect of MPFL surgery on patellofemoral cartilage contact area (CCA) during the first 30° of knee flexion.
UNASSIGNED: The purpose of this
study was to investigate the effect of MPFL reconstruction on CCA using magnetic resonance imaging (MRI). We hypothesized that patients with PFI would have a lower CCA than patients with healthy knees and that CCA would increase after MPFL reconstruction over the course of low knee flexion.
UNASSIGNED: Cohort
study; Level of evidence, 2.
UNASSIGNED: In a prospective matched-paired cohort
study, the CCA of 13 patients with low-flexion PFI was determined before and after MPFL reconstruction, and the data were compared with those of 13 healthy volunteers (controls). MRI was performed with the knee at 0°, 15°, and 30° of flexion in a custom-designed knee-positioning device. To suppress motion artifacts, motion correction was performed using a Moiré Phase Tracking system via a tracking marker attached to the patella. The CCA was calculated on the basis of semiautomatic cartilage and bone segmentation and registration.
UNASSIGNED: The CCA (mean ± SD) at 0°, 15°, and 30° of flexion for the control participants was 1.38 ± 0.62, 1.91 ± 0.98, and 3.68 ± 0.92 cm2, respectively. In patients with PFI, the CCA at 0°, 15°, and 30° of flexion was 0.77 ± 0.49, 1.26 ± 0.60, and 2.89 ± 0.89 cm2 preoperatively and 1.65 ± 0.55, 1.97 ± 0.68, and 3.52 ± 0.57 cm2 postoperatively. Patients with PFI exhibited a significantly reduced preoperative CCA at all 3 flexion angles when compared with controls (P ≤ .045 for all). Postoperatively, there was a significant increase in CCA at 0° of flexion (P = .001), 15° of flexion (P = .019) and 30° of flexion (P = .026). There were no significant postoperative differences in CCA between patients with PFI and controls at any flexion angle.
UNASSIGNED: Patients with low-flexion patellar instability showed a significant reduction in patellofemoral CCA at 0°, 15°, and 30° of flexion. MPFL reconstruction increased the contact area significantly at all angles.