■据报道,股骨前倾(FA)增加与髌骨脱位(PD)和滑车发育不良(TD)有关,FA的增加可能发生在股骨的不同节段。此外,TD与股骨后髁发育不良有关。在PD患者中,有或没有TD的FA是否更大仍不清楚。
■为了探讨PD和TD患者股骨不同节段的FA和扭转分布的差异,患有PD和无TD的患者,和性别和年龄匹配的对照组,并研究FA和股骨远端形态之间的关系。
■横断面研究;证据水平,3.
■这项研究涉及132个膝盖:44个患有PD和TD的膝盖,44膝盖有PD但没有TD,44控制膝盖。FA,近端扭转(PT),中扭转(MT),远端扭转(DT),测量股骨远端形态。通过单因素方差分析研究差异。进行Pearson相关分析以探讨FA与各参数之间的关联。
■有TD组的FA(25.4°±4.7°)明显大于其他组(对照:18.9°±5.6°;无TD组的PD:19.9°±4.8°)(P<.01)。TD组的DT(15.8°±2.9°)明显大于其他组(对照组:9.0°±4.3°;没有TD的PD:8.8°±3.9°)(P<0.01)。在所有三组中,FA与DT呈强烈正相关(对照,没有TD的PD,和PD与TD,分别为:r=0.76、0.80和0.88;P<0.01),与后内侧髁突长度呈极显著正相关(r=0.48,0.48,0.70;P<.01),与后外侧髁突长度呈极显著负相关(r=-0.30,-0.35,-0.78;P<.05)。
■TD膝盖的FA增加主要是由于DT而不是PT或MT,为股骨旋转截骨术的最佳位置选择提供参考。
UNASSIGNED: Increased femoral anteversion (FA) is reportedly associated with patellar dislocation (PD) and trochlear dysplasia (TD), and the increase in FA may occur at different segments of the femur. In addition, TD is associated with dysplasia of the posterior femoral condyle. Among patients with PD, whether FA is greater with or without TD remains unclear.
UNASSIGNED: To explore differences in FA and torsion distribution at different femoral sections among patients with PD and TD, patients with PD and no TD, and sex- and age-matched controls and to investigate the association between FA and distal femoral morphology.
UNASSIGNED: Cross-sectional study; Level of evidence, 3.
UNASSIGNED: This study involved 132 knees: 44 knees with PD and TD, 44 knees with PD but no TD, and 44 control knees. FA, proximal torsion (PT), middle torsion (MT), distal torsion (DT), and distal femoral morphology were measured. Differences were investigated by 1-way analysis of variance. Pearson correlation analysis was conducted to explore the association between FA and each parameter.
UNASSIGNED: FA was significantly larger in the PD with TD group (25.4° ± 4.7°) than in the other groups (controls: 18.9° ± 5.6°; PD without TD: 19.9° ± 4.8°) (P < .01). DT was significantly larger in the PD with TD group (15.8° ± 2.9°) than in the other groups (controls: 9.0° ± 4.3°; PD without TD: 8.8° ± 3.9°) (P < .01). In all 3 groups, FA was strongly positively correlated with DT (control, PD without TD, and PD with TD, respectively: r = 0.76, 0.80, and 0.88; P < .01), strongly positively correlated with the posteromedial condylar length (r = 0.48, 0.48, and 0.70; P < .01) and negatively correlated with the posterolateral condylar length (r = -0.30, -0.35, and -0.78, respectively; P < .05).
UNASSIGNED: The increased FA in knees with TD was due mainly to DT rather than PT or MT, which may provide a reference for choosing the optimal position for femoral derotation osteotomy.