髌股关节形态学与髌骨软化症之间相关性研究

目的　通过MRI进行髌股关节形态学参数测量，分析髌股关节形态与髌骨软化症之间的关联性。 方法　371例接受膝关节MRI检查的成人患者，诊断为髌骨软化症（chondromalacia patellae，CP）者纳入CP组（n=124），排除CP者纳入对照组（n=247），按性别分组计算CP患病率。通过MRI轴位片测量两组患者的外侧髌股角、滑车沟角、滑车沟深和外侧滑车倾斜角，根据软骨损伤的程度进一步将CP组分为CP（轻型）及CP（重型）两组。运用t检验对比CP组与对照组以及CP（轻型）组与CP（重型）组的各个参数组间差异。进一步运用χ2检验分析髌骨倾斜及滑车发育不良与CP的相关性。 结果　CP的患病率为33.42%（124/371），女性为49.35%（76/154），男性为22.12%（48/217），女性高于男性（P <0.01）；CP组与对照组在外侧髌股角（P =0.00），滑车沟角（P =0.00），滑车沟深（P =0.00）及外侧滑车倾斜角（P =0.02）上均有显著性差异。CP（轻型）组与CP（重型）组在外侧髌股角、滑车沟角、滑车沟深、外侧滑车倾斜角上均未见统计学差异（均P >0.25）。无论是否考虑性别因素，髌骨倾斜与滑车发育不良均与CP存在显著相关性（P =0.00）。 结论　髌骨倾斜及滑车发育不良与CP显著相关，但与CP的严重程度无关。

Correlation between patellofemoral morphology and chondromalacia patellae

Objective　To measure the morphological parameters of patellofemoral joint on MRI and analyze the etiological correlation between patellofemoral morphology and chondromalacia patellae (CP).　Methods　371 adult patients undergoing MRI examination were enrolled and those diagnosed with CP were included in the CP group（n=124）and others in the control group（n=247）. Prevalence rates of CP were recalculated and grouped according to gender. The lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle were measured in the MRI images on axial slices. The CP group was further divided into a mild and severe CP subgroup according to the degree of cartilage damage. The difference of patellofemoral morphology parameters among the CP group and control group, CP group (mild) and CP group (severe) were compared and the relationships among patella tilt, trochlear dysplasia and CP were further analyzed.　Results　The prevalence rate of CP was 33.42%, of which 49.35%was in women and 22.12%was in men. Significant differences in the lateral patellofemoral angle (P=0.00), sulcus angle (P=0.00), trochlear depth (P=0.00) and lateral trochlear inclination angle (P=0.02) could be found in the CP group and control group. However, there were no significant differences between patients in mild CP group and severe CP group in the lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle（all P>0.25）. Considered gender or not, patellar tilt and trochlear dysplasia were significant correlated with chondromalacia patellae（P=0.00）.　Conclusion　Patellar tilt and trochlear dysplasia are significantly correlated with CP but not the degree of CP.