CAJ | 학술논문

目的探讨MRI上髌骨横轴-股骨通髁线角在评估髌股关节排列紊乱中的作用.方法从2005年1月至2006年12月行膝关节镜手术的病例中选取主诉膝前痛、膝关节镜检查证实存在髌股关节软骨损伤的患者111例为损伤组;无膝前痛、膝关节镜检查证实髌股关节完好、仅有单纯半月板损伤的患者124例为对照组.所有研究对象均行膝关节MR检查,在MRI轴位图像上测量外侧髌股角、髌骨倾斜角(前)(以股骨前髁连线为参考)、髌骨倾斜角(后)(以股骨后髁连线为参考)及髌骨横轴-股骨通髁线角.为排除年龄与性别对结果的影响,损伤组与对照组按照性别相同、年龄相差3岁以内随机进行1:1配对,配对后采用配对没计资料t检验分析各参数在评估髌股关节排列紊乱中的作用.结果配对后外侧髌股角、髌骨倾斜角(前)、髌骨倾斜角(后)及髌骨横轴-股骨通髁线角在损伤组依次为18.94°±7.35°、6.89°±7.58°、6.89°±7.55°、6.55°±7.14°,在对照组依次为20.55°±6.25°、4.11°±4.02°、3.86°4±2.95°、3.76°±2.84°.两组外侧髌股角差异无统计学意义,而髌骨倾斜角(前、后)及髌骨横轴-股骨通髁线角差异有统计学意义.损伤组中股骨前髁骨缺损15例,股骨后髁骨缺损8例,未见股骨内、外上髁骨缺损.对照组骨质良好无缺损.结论髌骨横轴-股骨通髁线角是评估髌股关节排列紊乱的有效参数.
목적 탐토MRI상빈골횡축-고골통과선각재평고빈고관절배렬문란중적작용.방법 종2005년1월지2006년12월행슬관절경수술적병례중선취주소슬전통、슬관절경검사증실존재빈고관절연골손상적환자111례위손상조;무슬전통、슬관절경검사증실빈고관절완호、부유단순반월판손상적환자124례위대조조.소유연구대상균행슬관절MR검사,재MRI축위도상상측량외측빈고각、빈골경사각(전)(이고골전과련선위삼고)、빈골경사각(후)(이고골후과련선위삼고)급빈골횡축-고골통과선각.위배제년령여성별대결과적영향,손상조여대조조안조성별상동、년령상차3세이내수궤진행1:1배대,배대후채용배대몰계자료t검험분석각삼수재평고빈고관절배렬문란중적작용.결과 배대후외측빈고각、빈골경사각(전)、빈골경사각(후)급빈골횡축-고골통과선각재손상조의차위18.94°±7.35°、6.89°±7.58°、6.89°±7.55°、6.55°±7.14°,재대조조의차위20.55°±6.25°、4.11°±4.02°、3.86°4±2.95°、3.76°±2.84°.량조외측빈고각차이무통계학의의,이빈골경사각(전、후)급빈골횡축-고골통과선각차이유통계학의의.손상조중고골전과골결손15례,고골후과골결손8례,미견고골내、외상과골결손.대조조골질량호무결손.결론 빈골횡축-고골통과선각시평고빈고관절배렬문란적유효삼수.
Objective To explore the effect of the patella transverse axis-femoral transepieondylar axis angle (PFA) in the assessment of patellofemoral malalignment. Methods Among patients who under- went knee arthroscopy in our center from January 2005 to December 2006, 111 patients with chronic pateUofemoral cartilage lesions and anterior knee pain were selected as the lesion group, while 124 patients with isolated meniscus rupture without anterior knee pain were selected as the control group. All subjects underwent a knee MR examination. The patellofemoral alignments in both groups were assessed by lateral patellofemora] angle (LPA), patella tilt angle (anterior) (PTAA), patella tilt angle (posterior) (PTAP) and PFA, which were measured with eFilm Workstation software in their axial MR images. In order to eliminating the interference of gender and age, subjects were randomly matched 1 : 1 in accordance with the same gender, age difference was no more than 3 years old. Their differences between the two groups of the four parameters were analyzed with t test. Results After matching, the LPA, PTAA, PTAP and PFA in the lesion group were 18.94°±7.35°, 6.89°±7.58°, 6.89°±7.55°, 6.55°±7.14° respectively, and in the control group were 20.55°±6.25°, 4.11°±4.02°, 3.86°±2.95°, 3.76°±2.84° respectively. There were no significant statistical dif-ference in the LPA between the two groups, while significant statistical difference were found in PTAA, PTAP and PFA between the two groups. In the lesion group, bone defects were seen in 15 cases in the ante- rior femoral condyles, 8 cases in the posterior femoral condyles and not in the femoral epicondyles, while there were no cases with bone defects in the control group. Conclusion The PFA is an effective parameter in the assessment of patellofemoral malalignment.