膝关节骨关节炎不同分期与膝关节轴线角的相关性分析

Correlation Analysis between Knee Osteoarthritis in Different Stages and Knee Joint Axis Angle

目的：了解膝关节骨关节炎（KOA）不同分期与膝关节轴线角的相关性。方法：按照标准纳入研究对象796例中,健康正常人100例,影像学符合Kellgren/Lawrence（K/L）Ⅰ级的患者237例,Ⅱ级的患者142例,Ⅲ级的患者164例,Ⅳ级的患者153例。将健康正常人作为对照组,将K/L分级的Ⅰ-Ⅳ级分为一期组、二期组、三期组、四期组,按随机序列表方法,随机选取各组50例,男女各25例,共纳入250例。对正常健康人单侧和KOA拍摄患侧下肢全长正侧位X线片,通过在下肢全长X线片确定下肢轴线,分别测量股骨胫骨角、胫骨平台角、股骨下角、胫骨上角、关节间隙角、股骨髁干角并做比较。结果：经Spearman等级相关分析,股骨胫骨角、关节间隙角、胫骨平台角、胫骨上角与KOA K/L分期相关,且差异均有统计学意义（P〈0.01）;股骨髁干角与KOA K/L分期差异无统计学意义（P=0.756）;胫骨平台角与KOA K/L分期相关,差异有统计学意义（P〈0.01）。结论：1）冠状位轴线角中关节间隙角、股骨下角、胫骨上角、股骨胫骨角与KOA严重程度相关;2）矢状面轴线角中股骨髁干角与KOA无相关性;胫骨平台角与KOA严重程度相关。

Objective ： To identify the correlation between knee joint axis angle and knee osteoarthritis in different stages. Methods：According to the standard of 796 cases, 100 cases of healthy people,237 patients with K/L Ⅰ grade,142 patients with grade 11 , 164 patients with grade Ⅲ ,153 patients with grade Ⅳ. Healthy people as the control group,the patients of K/L Ⅰ-Ⅳ level were divided into stage Ⅰ group,stage Ⅱ group,stageⅢ group and stage Ⅳ group. According to the ran- dom sequence table,50 cases of each group were randomly selected,with a gender ratio of half to half. A total of 250 cases were included. All the people took the lower limb X ray to determine the axis of the lower extremity. Measurements were made on the femoraltibial angle,tibial plateau angle,lower femoral angle, upper tibial angle,joint space angle and femoral condyle-shaft angle, and a comparison was made. Results：Spearman grade correlation analysis showed that the femoraltibial angle,joint space angle,tibial plateau angle and upper tibial angle were positively correlated with K/L KOA stage,and all had significant difference （P〈0.01）. There was no significant difference between the femoral condyle-shaft angle and K/ L KOA stage （P=0. 756〉0.05）. The tibial plateau angle was negatively correlated with K/L KOA stage,and the differ- ence was statistically significant （P〈0.01）. Conclusion： 1）The joint space angle, lower femoral angle, upper tibial angle and the femoraltibial angle were positively correlated with the severity of KOA. 2）In the sagittal axis, there was no corre- lation between the femoral condyle-shaft angle and KOA, and the tibial plateau angle was negatively correlated with the se- verity of KOA.