目的探讨滑车发育不良(TD)和髌骨类型与双侧髌骨(BP)的关系。材料与方法回顾性分析了在我院进行的5,081例膝关节MRI。有膝关节手术史的患者,以前或最近的创伤,和风湿病受累被排除在研究之外.对49例髌骨患者进行MRI检查。排除了三名患者:两名患者有三方变异,一个有多个骨发育不良的发现。总的来说,46例BP患者被纳入研究。BP被分类为I型,II,和III。根据二分片段和邻近髌骨内是否存在水肿,将患者分为有症状和无症状组。根据髌骨类型检查患者,滑车发育不良,结节-滑车沟(TT-TG)差,沟角,和沟深度。结果46例患者(男28例,女18例),平均年龄33±9.5岁,范围:18-54)。三十八段(82.6%)为III型,八段(17.4%)为II型。没有I型BP。17人(36.9%)有症状,29例(63.1%)无症状。II型中的7个(87.5%)和III型中的10个(26.3%)二分片段有症状。在有症状的患者中,滑车发育不良的频率和程度(分别为p=0.007和p=0.041)更高。症状组滑车沟角较高(p=0.007),滑车深度较低(p=0.006)。在TT-TG差异方面没有发现统计学上的显著差异(p=0.247)。III型和IV型髌骨在有症状组中更常见。结论目前的研究表明,髌股不稳定和髌骨类型与症状性BP有关。滑车发育不良患者,II型BP,和不成比例的髌骨小关节可能显著增加症状性BP的风险。
Purpose The aim of this study is to investigate the relationship of trochlear dysplasia (TD) and patella type with
bipartite patella (BP). Materials and methods A total of 5,081 knee MRIs taken in our institution were reviewed retrospectively. Patients with a history of knee surgery, previous or recent trauma, and rheumatologic involvement were excluded from the study. The MRIs of 49 patients with
bipartite/multipartite patella were detected. Three patients were excluded: two patients had a tripartite variant, and one had multiple osseous dysplastic findings. Overall, 46 patients with BP were included in the study. BPs were classified as type I, II, and III. Patients were divided into symptomatic and asymptomatic groups according to the presence of edema within the
bipartite fragment and adjacent patella. Patients were examined in terms of patella type, trochlear dysplasia, tuberosity-trochlear groove (TT-TG) difference, sulcus angle, and sulcus depth. Results There were 46 patients with BP (28 males and 18 females) (mean age: 33±9.5 years, range: 18-54). Thirty-eight
bipartite fragments (82.6%) were type III and eight (17.4%) were type II. There was no type I BP. Seventeen (36.9%) were symptomatic, and 29 (63.1%) were asymptomatic. Seven of the type II (87.5%) and 10 of the type III (26.3%)
bipartite fragments were symptomatic. The frequency and degree of trochlear dysplasia (p=0.007 and p=0.041, respectively) were found to be higher in symptomatic patients. The trochlear sulcus angle was higher (p=0.007) and the trochlear depth was lower (p=0.006) in the symptomatic group. No statistically significant difference was found (p=0.247) in terms of TT-TG difference. Type III and type IV patella were more common in the symptomatic group. Conclusion The current study shows that patellofemoral instability and patella type are associated with symptomatic BP. Patients with trochlear dysplasia, type II BP, and disproportionate patellar facet may have a significantly increased risk of symptomatic BP.