基于VHS技术对髌骨倾斜轨迹变化趋势及其分类的探讨

A VHS technology-based study on variation trend and classification of patellar tracking in patients with patellar tilt

目的基于容积螺旋穿梭(VHS)技术探讨髌骨倾斜(PT)的轨迹变化趋势并进行分类。方法选择PT患者32例40膝为病例组,正常30例30膝为对照组,使用VHS技术行膝关节扫描,重建其屈膝活动图像。测量胫股关节伸直位、屈膝1〜10°、11〜20°、21〜30°、31〜40°时的髌骨倾斜角(PTA)和外侧髌股角(LPFA),并绘制相应的髌骨运动轨迹曲线,对两组曲线进行分析、分类。结果病例组与对照组PTA、LPFA于胫股关节屈曲0〜30°区间内其数值具有统计学差异(P<0.05),病例组数值高于对照组;屈膝31〜40°时PTA值两组间有统计学差异(P<0.05),LPFA无显著差异(P>0.05)。对照组PT轨迹可分为两种类型,病例组PT轨迹可分为3种类型。结论基于VHS技术的髌骨运动轨迹成像,既可以对PT进行静态量化分析,又可对异常轨迹的动态趋势进行描述、分类,有助于PT病因的分析及指导个体化术式的制定。

Objective To explore the variation trend and classification of patellar tracking in the cases of patellar tilt(PT) using the volume helical shuttle(VHS) technology. Methods A total of 40 knees of patients with PT were included in the case group and30 normal knees included in the control group. All knee joins were scanned using the VHS technology to reconstruct the knee flexion tracking image. The patellar tilt angle(PTA) and lateral patellofemoral angle(LPFA) at tibiofemoral joint extension, flexion 1-10°,11-20°, 21-30°, and 31-40° were measured. The corresponding patellar tracking curves of the two groups were drawn and analyzed and classified. Results The PTA and LPFA values were statistically different(P < 0.05) between the two groups at tibiofemoral joint flexion of 0-30°, and the values of the case group were higher than those of the control group. The PTA value was statistically different(P < 0.05) between the two groups at flexion of 31-40°, while LPFA showed no significant difference(P > 0.05). The PT tracking of the control group could be divided into two types, and PT tracking of the case group could be divided into three types. Conclusion The imaging of patellar tracking based on VHS can not only perform static quantitative analysis on PT, but also describe and classify the dynamic trend of maltracking, which is helpful for the analysis of the causes of PT and guides the development of individualized surgical procedure.