急性髌骨外侧脱位者与非接触性前交叉韧带撕裂者间髌股关节磁共振参数的比较

Comparative analysis of patellofemoral joint magnetic resonance images in acute lateral patellar dislocation and non-contact anterior cruciate ligament tear

目的对比分析急性髌骨外侧脱位(LPD)者、非接触性前交叉韧带(ACL)撕裂者及正常人群间髌股关节主要解剖参数间的异同点,以探讨导致LPD与非接触性ACL撕裂的潜在解剖因素。方法分别对49例急性LPD患者、63例非接触性ACL撕裂患者和120例膝关节正常对照者的磁共振成像(MRI)资料进行回顾性分析,将三者间股骨滑车发育不良类型、髌骨高度、胫骨结节-股骨滑车沟(TT-TG)间距三大解剖参数进行对比分析。结果急性LPD组股骨滑车发育不良发生例数明显高于非接触性ACL撕裂组和对照组,P<0.01;急性LPD组髌骨高位发生例数明显高于非接触性ACL撕裂者和对照组,P<0.05;非接触性ACL撕裂组中髌骨高位发生例数高于正常对照组,P<0.05;急性LPD组TT-TG间距过大发生例数明显高于非接触性ACL撕裂组和对照组,P<0.05。结论通过分析急性LPD组与非接触性ACL组的磁共振参数,发现髌骨高位与非接触性ACL撕裂具有一定的相关性,是导致非接触性ACL撕裂的危险解剖因素。

Objective To compare the main anatomical variants of the patellofemoral joint among patients with acute lateral patellar dislocation(lateral patellar dislocation,LPD),non-contact(anterior cruciate ligament,ACL)tear and the general people,and to evaluate the potential dangerous factors preprodise to LPD and the non-contact ACL tear.Methods The MRI data of 49 patients with acute LPD,63 patients with non-contact ACL tear and 120 patients with normal knee joint were analyzed retrospectively.The three anatomical variants of the patellofemoral joint,including trochlear dysplasia,patella alta,tibial tuberosity-trochlear groove(TT-TG istance)were compared and analyzed.Results The incidence rate of trochlear dysplasia in the acute LPD group was significantly higher than those of the non-contact ACL tear group and the normal group(P<0.01).The incidence rate of patella alta in the acute LPD group was significantly higher than those of the non-contact ACL tear group and the normal group(P<0.05).The incidence rate of patella alta in the non-contact ACL tear group was significantly higher than the normal group(P<0.05).The incidence rate of the elevated TT-TG distance in the acute LPD group was significantly higher than those of the non-contact ACL tear group and the normal group(P<0.05).Conclusion By analyzing the MRI parameters of acute LPD group and non-contact ACL group,patella alta is correlative with the non-contact ACL tear,which is an anatomical factor predisposes to non-contact ACL tear.