髌骨形态异常与膝关节骨关节炎之间相关性

摘要

目的：利用计算机辅助测量技术，对一定样本量的甘肃省中医院影像科膝关节X线片进行骨形态测量和相关比值分析研究，得出膝关节相关参数的正常范围，确立膝关节发育缺陷与膝关节骨关节炎之间相关性，找出导致髌股关节骨关节炎的骨性致病因素。方法测量指标：股骨髁宽度、胫骨髁宽度、髌骨宽度、髌骨纵径、髌骨关节面高度、髌骨厚度、髌骨下缘与关节间隙距离、股骨内髁前后径、胫骨平台前后径、髌骨关节面距胫骨平台距离、髌骨中点距股骨纵轴距离，采用SPSS 17.0软件对各有关比值进行处理和分析，采用90%（p5~p95）医学参考范围为正常参考范围描述；计数资料采用χ2检验，设检验水平为0.05，P<0.05为差异有显著性意义。结果通过测量136例正常膝关节X线片各骨形态数据及相关比值，以90%医学参考范围为正常范围，得出髌骨厚度/股骨内髁前后径：0.162362~0.335135，髌骨纵径/髌骨关节面高度：1.217105~1.643902为正常范围。以此标准在481例膝关节骨关节炎病例中，髌骨厚度/股骨内髁前后径异常率6.4%，髌骨纵径/髌骨关节面高度异常率23.5%。结论髌骨偏厚、髌骨偏薄等形态异常在膝骨关节炎中占有一定的比例且女性发病率高于男性。%Objective To got the normal range of knee relevant parameters,established the correlation between defect of knee joint development with knee osteoarthritis and find the causes of bony pathogenic factors of patellofemoral osteoarthritis. Methods The following datat was collected:femoral condyle wide,( WFC),tibia condyle patella wide( WTP),patellar width ( WP),patella longitudinal diameter( HP),the articular surface of the patella length( LPAS),patellar thickness( DP),the pa-tella and the lower edge of the joint gap distance( PIAGD),before and after the medial condyle of the femur diameter( SLM-FC),tibial anteroposterior diameter( SLTP),patellar articular surface of tibial platform from a distance( ASPDTP),distance from the halfway point of the femoral patella to wheelbase of femur( HFLAFVD). We processed and analyzed the relevant ratio using SPSS17. 0 software and using 90%(p5~p95)of medical reference range of normal reference range description and pro-cessed count material byχ2-Test and the inspection level set for 0. 05. There was a significant difference when P<0. 05. Re-sults 90% medical reference range is the normal range through measuring normal knee joint X film of the bone morphologi-cal data and correlation ratio of 136 cases,WP/ WFC:0. 490 489~0. 659 016. Abnormal rate of WP/ WFC is 8. 5% in 481 patients with knee osteoarthritis. Conclusion Morphological abnormalities in knee osteoarthritis such as patella partial thick-ness and thin occupy a certain proportion and occurrence rate of female is higher than male.