目的 对比急性髌骨外侧脱位(LPD)患者髌骨形态与健康人群形态诊断分布差异,并分析其与性别、髌股关节解剖参数的相关性。方法 回顾性分析2023-01至2025-11武警山东总队医院临床诊断为急性LPD 71例MRI资料,并随机选取100名健康者,对比两者髌骨形态类型分布,分析患者性别、髌股关节解剖参数[髌骨位置、胫骨结节-股骨滑车沟(TT-TG)间距、股骨滑车类型]与其髌骨形态的相关性。结果 LPD组(男30例/女41例)髌骨Wiberg Ⅰ型3例、Ⅱ型35例、Ⅲ型33例,对照组(男性57例/女性43例)Ⅰ型9例、Ⅱ型85例、Ⅲ型6例,两组分型差异具有统计学意义(P<0.05)。LPD组中:(1)髌骨位置正常组(Ⅱ型24例/Ⅲ型13例)与高位组(Ⅱ型11例/Ⅲ型20例)分型差异显著(P=0.016);(2)TT-TG间距正常组(Ⅱ型28例/Ⅲ型21例)与间距过大组(Ⅱ型7例/Ⅲ型12例)分型差异无统计学意义;(3)股骨滑车发育正常组(Ⅱ型15例/Ⅲ型3例)、轻度不良组(Ⅱ型15例/Ⅲ型13例)、重度不良组(Ⅱ型5例/Ⅲ型17例)间分型差异有统计学意义(P=0.001),组间两两比较,重度不良组与正常组、重度不良组与轻度不良组、轻度不良组与正常组间差异均有统计学意义(P＜0.05)。结论 急性LPD者和健康人群间髌骨分型具有显著差异,LPD者髌骨Wiberg Ⅱ、Ⅲ型常见,Ⅰ型非常少见,股骨滑车形态、髌骨位置与其髌骨分型分布具有一定的相关性,股骨滑车发育不良程度越重者越易于伴发髌骨Wiberg Ⅲ型,髌骨高位者易于伴发髌骨Wiberg Ⅲ型。
Abstract
Objective To compare the differences in patellar morphological type distribution between patients with acute lateral patellar dislocation (LPD) and healthy individuals, and to analyze its correlation with gender and anatomical parameters of the patellofemoral joint. Methods The MRI data of 71 patients diagnosed with acute LPD from January 2023 to November 2025 Shandong Provincial Corps Hospital of Chinese People’s Armed Police Force were retrospectively analyzed and 100 healthy individuals were randomly selected. The distribution of patellar morphology types between the two groups was compared, and the correlation between the patient’s gender, patellofemoral joint anatomic parameters (patellar position, tibial tuberosity-trochlear groove (TT-TG) distance, and patellar trochlear type) and patellar morphology were analyzed. Results In the LPD group (30 males /41 females), there were 3 cases of Wiberg type I, 35 cases of type Ⅱ, and 33 cases of type Ⅲ. In the control group (57 males/43 females), there were 9 cases of type I, 85 cases of type II, and 6 cases of type Ⅲ. There was significant difference in the distribution of patella morphology between the two groups (P<0.05). Subgroup analyses in the LPD group revealed: significant difference in patellar type distribution between the normal patellar position group (24 type Ⅱ /13 type Ⅲ) and the high postion group (11 type Ⅱ /20 type Ⅲ) (P=0.016); no statistically significant difference between the normal TT-TG distance group (28 type Ⅱ/21 type Ⅲ) and the elevated TT-TG distance group (7 type Ⅱ/12 type Ⅲ); statistically significant differences in type distribution among the normal trochlea group (15 type Ⅱ/3 type Ⅲ), low-grade trochlear dysplasia group (15 type Ⅱ/13 type Ⅲ), and high-grade trochlear dysplasia group (5 type Ⅱ/17 type Ⅲ) (P=0.001). Significant differences were observed between the high-grade trochlear dysplasia group and the normal group, the high-grade trochlear dysplasia group and the low-grade trochlear dysplasia group, and the low-grade trochlear dysplasia group and the normal group (P<0.05). Conclusions There are significant differences in patellar type distribution between LPD patients and healthy individuals. Type II and III of the patellae are common in LPD patients, while type I is very rare. The morphology of the femoral trochlea and patellar position have a certain correlation with the distribution of patellar types. The more severe the dysplasia of the femoral trochlea, the more likely it is to be accompanied by Wiberg type Ⅲ patella. Patella with a high position is more likely to be accompanied by Wiberg Ⅲ patella.
关键词
膝关节 /
髌骨脱位 /
髌骨形状 /
解剖参数 /
磁共振成像
Key words
knee joint /
patellar dislocation /
patellar morphology /
anatomic parameter /
magnetic resonance imaging
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