比较前交叉韧带撕裂与髌骨外侧脱位患者髌股关节解剖学参数异常检出率

Detection rate of abnormal anatomical parameters of patellofemoral joint between anterior cruciate ligament tear and lateral patellar dislocation

目的对比前交叉韧带(ACL)撕裂与髌骨外侧脱位(LPD)患者之间,股骨滑车发育不良、髌骨高位、胫骨结节-股骨滑车沟(TT-TG)间距过宽检出率的差异。方法回顾性分析79例ACL撕裂患者(ACL撕裂组)、46例LPD患者(LPD组)及100例膝关节未见明显异常者(对照组)的膝关节MRI,对比3组间股骨滑车发育不良、髌骨高位(Insall-Salvati指数>1.2)及TT-TG间距过宽(TT-TG间距>15 mm为过宽)检出率的差异。结果ACL撕裂组中,股骨滑车发育不良18例(18/79,22.78%),髌骨高位12例(12/79,15.19%),TT-TG间距过宽10例(10/79,12.66%);LPD组中,股骨滑车发育不良26例(26/46,56.52%),髌骨高位21例(21/46,45.65%),TT-TG间距过宽13例(13/46,28.26%);对照组股骨滑车发育不良9例(9/100,9.00%),髌骨高位6例(6/100,6.00%),TT-TG间距过宽5例(5/100,5.00%)。3组间股骨滑车发育不良、髌骨高位和TT-TG间距过宽检出率差异均有统计学意义(P均<0.01);LPD组股骨滑车发育不良、髌骨高位检出率均高于对照组及ACL撕裂组(P均<0.05),TT-TG间距过宽检出率高于对照组(P<0.05);ACL撕裂组TT-TG间距过宽检出率与LPD组及对照组差异均无统计学意义(P均>0.05)。结论股骨滑车发育不良、髌骨高位及TT-TG间距过宽在ACL撕裂与LPD患者中的检出率均较高;前二者在LPD中尤为显著。

Objective To compare the detection rates of femoral trochlea dysplasia,patella alta and elevated tibial tubercle-trochlear groove(TT-TG)distance between patients with anterior cruciate ligament(ACL)tear and lateral patellar dislocation(LPD).Methods MRI data of 79 patients with ACL tear(ACL tear group),46 patients with LPD(LPD group)and 100 controls with no obvious knee abnormalities(control group)were retrospectively analyzed.The detection rates of femoral trochlea dysplasia,patella alta(Insall-Salvati index>1.2)and elevated TT-TG(TT-TG spacing>15 mm)were compared among 3 groups.Results In ACL tear group,femoral trochlea dysplasia was detected in 18 cases(18/79,22.78%),patella alta in 12 cases(12/79,15.19%),while elevated TT-TG was found in 10 cases(10/79,12.66%).In LPD group,femoral pulley dysplasia was detected in 26 cases(26/46,56.52%),patella alta in 21 cases(21/46,45.65%),and elevated TT-TG was found in 13 cases(13/46,28.26%).In control group,9 cases(9/100,9.00%)of femoral trochlea dysplasia,6 cases(6/100,6.00%)of patella alta and 5 cases(5/100,5.00%)of elevated TT-TG were observed.There were significant differences of detection rates of femoral trochlea dysplasia,patella alta and elevated TT-TG among 3 groups(all P<0.01).The detection rates of femoral trochlea dysplasia and patella alta in LPD group were higher than those in ACL tear group and control group(all P<0.05),whose elevated TT-TG was higher than that in control group(P<0.05).There was no significant difference of the detection rate of elevated TT-TG in ACL tear group compared with that in LPD group and control group(both P>0.05).Conclusion The detection rates of femoral trochlea dysplasia,patella alta and elevated TT-TG were rather high in both ACL tear and LPD patients,especially the former two in LPD patients.