Knee joint parameters are significant for anterior knee pain

doi:10.3969/j.issn.2095-4344.2013.09.017

Abstract

Abstract:

BACKGROUND: The abnormality of some parameters such as congruence angle has statistical significance on anterior knee pain has been confirmed under CT measurement, but has not been confirmed through clinical operations.
OBJECTIVE: To analyzes the relationship between the parameter of knee joint and anterior knee pain through measuring the parameters such as congruence angle, patellofemoral index, lateral patellofemoral angle and tilt angle.
METHODS: Fifty patients with anterior knee pain caused by varying degrees of atellofemoral cartilage damage were included, and the parameters such as congruence angle, patellofemoral index, lateral patellofemoral angle and tilt angle were measured on the patellar X-ray axial film. The parameters were compared with those of the other 50 patients without anterior knee pain and only with meniscus injury.
RESULTS AND CONCLUSION: There were significant differences in congruence angle, patellofemoral index and tilt angle on the patellar X-ray axial film, and there was no significant difference in lateral patellofemoral angle. The congruence angle and patellofemoral index have important diagnosis value for the patients with anterior knee pain caused by patellofemoral joint disorders and are considered as the most effective parameters which has clinical efficacy for the patients with patellofemoral joint disorders.

Key words: bone and joint implants, basic experiment of bone injury, knee joint parameters, anterior knee pain, hip joint replacement, congruence angle, patellofemoral index, tilt angle, lateral patellofemoral angle, patellofemoral joint disorder, X-ray film, axial view of the patella, photographs-containing paper of bone and joint implants

CLC Number:

R318

Sui Jin-po, Ge Bang-rong, Yang Wen-feng, Duan Guo-qing, Zhang Yuan-min, Zhao Xiao-wei, Xie Shi-cheng. Knee joint parameters are significant for anterior knee pain[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(9): 1633-1640.

Figures/Tables 2

膝前疼痛组患者的髌股指数比无膝前疼痛组患者的髌股指数普遍偏大，差异有显著性意义，说明髌股关节间隙不对称，髌骨向外侧倾斜，存在半脱位倾向。膝前疼痛组髌骨合适角比无膝前疼痛组更大，说明髌股关节疼痛组的髌骨有明显的倾斜和外移。髌股指数、合适角异常是反映髌股关节紊乱的指标，髌股关节紊乱是导致膝前疼痛的重要原因。外侧髌股角两组数据差异无显著性意义，说明膝前疼痛组患者髌骨倾斜度较大，易导致半脱位。髌股指数与合适角易于测量，临床上易于掌握，误差小，故在临床上的测量易于推广普及，可作为广大医疗工作者诊断膝前疼痛的两个重要参数。 2.3 膝前疼痛患者疗效分析膝前疼痛组50例患者中42例行关节镜下软骨修整加外侧支持带松解，治疗中可动态观察髌股关节运动轨迹，可更直观的观察内外侧髌股关节内外侧间隙及髌骨的倾斜，治疗中发现行外侧支持带松解后发现髌骨运动轨迹恢复至原来相对应的股骨髁中央位置，8例膝关节内翻患者行膝关节表面置换，置换过程中发现均有骨赘形成、Ⅳ度外侧髌股关节软骨损伤和不同程度髌骨倾斜及半脱位，均给予外侧支持带松解，对于内翻畸形通过截骨及软组织平衡得到纠正，恢复了膝关节力线。50例患者治疗后无感染，无关节血肿、皮肤水疱、关节粘连。50例患者随访2年到3年不等，采用膝关节HSS评分标准，优良率89.56%。实验结果说明膝前疼痛的患者在手术中确实存在髌骨倾斜和偏移，且手术纠正髌骨的倾斜和偏移后膝前疼痛消失，说明膝前疼痛与髌骨的倾斜和偏移有相关性，即膝前疼痛与髌股关节紊乱有相关性[6]，而膝前疼痛的患者膝关节参数均有异常，由此说明膝关节参数的异常是膝前疼痛的重要指标。"

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