■在髌骨不稳定的背景下,髌骨内侧小平面病变已得到很好的描述。然而,对无创伤性髌骨内侧小关节病变的危险因素知之甚少。
■确定无外伤或髌骨不稳定病史患者髌骨内侧小关节病变的临床和影像学危险因素。据推测,相对于滑车沟的胫骨后结节将是无创伤内侧髌骨小关节病变的危险因素。
■病例对照研究;证据水平,3.
■共有37例无创伤性髌骨内侧小关节病变患者按年龄匹配,性别,和体重指数与37例没有髌股发育不良病史的对照患者。比较两组人口统计学和影像学特征。X线照相术用于评估Wiberg类型,磁共振成像用于计算卡顿-德尚指数,胫骨结节-滑车沟距离,滑车小面不对称比,髌骨指数,沟深度,髌骨平分比,和胫骨结节高度。单变量分析中具有统计学意义的变量被用作多元回归模型的输入,以评估独立的危险因素。
■就Wiberg类型而言,组间没有差异,卡顿-德尚指数,胫骨结节-滑车沟距离,沟深度,或髌骨指数(全部P>0.05)。内侧小关节病变组内侧滑车小关节较大(滑车小关节不对称比,0.72±0.11vs0.60±0.09;P<.001),滑车沟更内侧的髌骨(髌骨平分比,0.57±0.06vs0.55±0.07;P=.035),和相对于滑车沟更靠后的胫骨结节(胫骨结节高度,与对照组相比,-3.13±5.21vs-0.23±5.93mm;P=.030)。多因素回归分析确定滑车小关节面不对称和胫骨结节高度是髌骨内侧小关节病变的独立危险因素(相对风险=97.3[95%CI,14.9-635.1],P<.001,相对风险=0.95[95%CI,0.92-0.98],分别为P=.004)。
■在没有外伤或髌骨不稳定病史的患者中,相对较大的内侧滑车小关节和相对于滑车沟较后的胫骨结节是髌骨内侧小关节病变的危险因素。
UNASSIGNED: Medial patellar facet lesions have been well-described in the setting of patellar instability. However, relatively little is known about risk factors for atraumatic medial patellar facet lesions.
UNASSIGNED: To identify clinical and radiographic risk factors for medial patellar facet lesions in patients without a history of trauma or patellar instability. It was hypothesized that a posterior tibial tubercle relative to the trochlear groove would be a risk factor for atraumatic medial patellar facet lesions.
UNASSIGNED: Case-control study; Level of evidence, 3.
UNASSIGNED: A total of 37 patients with atraumatic medial patellar facet lesions were matched by age, sex, and body mass index with 37 control patients without a history of patellofemoral dysplasia. Demographic and imaging characteristics were compared between groups. Plain radiography was used to evaluate Wiberg type, and magnetic resonance imaging was used to calculate Caton-Deschamps index, tibial tubercle-trochlear groove distance, trochlear facet asymmetry ratio, patellotrochlear index, sulcus depth, patellar bisect ratio, and tibial tubercle height. Statistically significant variables from univariate analysis were used as inputs to the multivariate regression model to assess independent risk factors.
UNASSIGNED: There were no differences between groups with respect to Wiberg type, Caton-Deschamps index, tibial tubercle-trochlear groove distance, sulcus depth, or patellotrochlear index (P > .05 for all). The medial facet lesion group had a larger medial trochlear facet (trochlear facet asymmetry ratio, 0.72 ± 0.11 vs 0.60 ± 0.09; P < .001), a more medial-lying
patella in the trochlear groove (patellar bisect ratio, 0.57 ± 0.06 vs 0.55 ± 0.07; P = .035), and a more posterior tibial tubercle relative to the trochlear groove (tibial tubercle height, -3.13 ± 5.21 vs -0.23 ± 5.93 mm; P = .030) compared with the control group. Multivariate regression analysis identified trochlear facet asymmetry and tibial tubercle height as independent risk factors for medial patellar facet lesions (relative risk = 97.3 [95% CI, 14.9-635.1], P < .001 and relative risk = 0.95 [95% CI, 0.92-0.98], P = .004, respectively).
UNASSIGNED: A relatively larger medial trochlear facet and a more posterior tibial tubercle relative to the trochlear groove were found to be risk factors for medial patellar facet lesions in patients without a history of trauma or patellar instability.