膝骨性关节炎病程与患侧踇外翻的相关性

Investigation of Relativity between Knee Osteoarthritis Disease Stage and Hallmark Valgus on the Lsion Side

目的探究膝骨性关节炎患者病程与患侧踇外翻严重程度的相关性。方法将2011年3月至2017年10月在云南省中医医院骨科住院部(35例)及昆明市中医医院骨科住院部(52例)诊断为踇外翻及同侧KOA并符合纳入标准的87例患者纳入研究。依据KOA分期将87例研究对象分为I期组17例、II期组35例、III期22例、IV期13例;根据正常胫股解剖角得膝内翻组患者33例、膝外翻组患者23例;对比不同KOA分期组及内、外翻2组患者间HVA、IMA、PASA及DASA的差异。结果 4个KOA分期组比较:与I期组、II期组比较III期、IV期组HVA较大,P<0.05;IMA:II期组显著大于I期组,P<0.01,与II期组比较,III期组、IV期组IMA较大,P<0.05; PASA:II期组显著大于I期组,P<0.01,II期组、III期组、IV期组无差异;DASA:II期组显著大于I期组,P<0.01,II期组、III期组、IV期组无差异。膝内翻组与膝外翻组比较:膝内翻组HVA(28.7±2.8) vs (33.5±3.5),平均值显著较小,P<0.01, IMA (12.7±2.5) vs (14.3±2.7)、PASA (10.1±2.5)vs (11.6±2.2)、DASA (11.7±2.1 VS 12.9±2.3)较小,P<0.05。与膝内翻组比较,膝外翻组III、IV期KOA患者比例较高(36.3%vs 56.5%),P<0.05。结论踇外翻与膝骨性关节炎两者之间具有一定的正相关性,而对于膝外翻膝骨性关节炎患者来说,这种相关性更为明显。

Objective To investigate the relationship of Knee Osteoarthritis stage and Hallmark valgus severity on the same lesion side.MethodFrom march 2011 to October 2017,87 patients diagnosed as KOA and Hallmark valgus on the same lesion side complying with the inclusion criteria were selected as research subjects(35 cases from YunNan Province TCM Hospital,and 52 cases from Kunming municipal TCM Hospital).According to relative standard 87 cases were divided into KOAⅠstage group(17 cases),KOAⅡstage group(35),KOAⅢstage group(23),and KOAⅣstage group(13cases).According common tibiofemoral anatomic angle we grouped 33 cases into the bandy knee group and 23 cases into the baker knee group.Compareing the differences of HVA,IMA,PASA and DASA between the four KOA stage groups as well as the bandy knee group and the baker knee group.ResultThe four KOA stage groups:HVA:the average HVA values of KOAⅢstage group and KOAⅣstage group were higher than those of the KOAⅠstage group and KOAⅡstage group,P<0.05.IMA:the IMA values of KOAⅡstage group were obviously higher than that of KOAⅠstage group,P<0.01.Compared with KOAⅡstage group,IMA of KOAⅢstage group and KOAⅣstage group were higher,P<0.05.PASA:the PASA value of KOAⅡstage group was obviously higher than that of KOAⅠstage group,P<0.01.The PASA values of KOAⅡstage group,KOAⅢstage group and KOA IV stage group had no difference.DASA:the DASA value of KOAⅡstage group was obviously higher than that of KOAⅠstage group,P<0.01.The PASA value of KOAⅡstage group,KOAⅢstage group and KOAⅣstage group had no difference.Bandy knee group and Baker knee group:Compared with the baker group,HVA of the bandy group was obviously lower(28.7±2.8)VS(33.5±3.5),P<0.01.IMA of the bandy group was lower(12.7±2.5)VS(14.3±2.7),P<0.05.PASA of the bandy group was lower(10.1±2.5)VS(11.6±2.2),P<0.05.DASA of the bandy group was lower(11.7±2.1)VS(12.9±2.3),P<0.05.Compared with the bandy group,the KOAⅢand KOAⅣstage patients proportion of the baker group was higher(36.3%VS 56.5%),P<0.05.Conclusion There might be positive relativity between hallmark valgus and Knee Osteoarthritis,especially for KOA patients with baker knee.