TT-TG间距在复发性髌骨不稳诊断中的价值

发布时间：2018-07-15 14:24

【摘要】：目的髌骨不稳的临床诊断中,因缺乏特征性体征表现,需结合患者的病史以及影像学的表现做出综合性的判断。近年来国内外相关研究发现髌骨不稳患者的胫骨结节股骨滑车沟(tibial tuberosity-trochlear groove. TT-TG)间距较正常人群的TT-TG间距增大,表现出与髌股关节不稳相关。然而单侧复发性髌骨不稳患者患侧膝关节与健侧膝关节TT-TG间距的差异的临床研究较少,本研究旨在通过比较二者之间的差异,评价TT-TG间距在指导对此类人群诊疗过程中的价值。方法对我院2010年1月-2013年12月住院及门诊第一诊断考虑髌骨不稳的患者,通过电话随访、预约复诊的方式,对复诊的患者进行结依据病史资料、体格检查及影像学表现的综合性筛选,对符合条件的患者进行患侧与健侧膝关节的进行CT检查,获取患者的详细病史并对检查数据进行综合分析,分析患者的受伤机制,损伤关节的左、右侧分布,比较二者之间TT-TG间距的差异,从而评价TT-TG间距在单侧复发性髌骨不稳患者临床诊断中的价值。结果34例患者,男性7例,女性27例,年龄14～31岁,左侧膝关节出现髌骨不稳的患者一共13例,出现右侧膝膝关节髌骨不稳的患者一共21例；53%的患者第一脱位的直接原因是外伤；34名患者患侧TT-TG距离为(16.47±3.87)mm,健侧TT-TG距离为(15.61±3.52)mm,两者之间比较差异无统计学意义(P0.05)。结论TT-TG间距作为髌骨不稳的高危因素,在单侧复发性髌骨不稳的患者中,患侧TT-TG距离为(16.47±3.87)mm,健侧TT-TG距离为(15.61±3.52)mm,两者之间比较差异无统计学意义(P0.05)。但健侧的膝关节有发展为髌骨不稳的趋势,且随着病程的延长,这种趋势更加明显。在临床工作中,应将各项评估参数综合分析,以明确髌骨不稳的诊断,并应在探索针对髌骨不稳有较高特异性的评估方式方面进行更多的研究。
[Abstract]:Objective in the clinical diagnosis of patellar instability, due to the lack of characteristic signs, it is necessary to make a comprehensive judgment based on the patient's history and imaging findings. Recent studies at home and abroad have found tibial tuberosity-trochlear grooveves in patients with patellar instability. The distance of TT-TG was larger than that of normal subjects, which was related to patellofemoral joint instability. However, there are few clinical studies on the difference of TT-TG spacing between the affected and healthy knee joints in patients with unilateral recurrent patellar instability. The purpose of this study was to evaluate the value of TT-TG spacing in guiding the diagnosis and treatment of this kind of people by comparing the differences between the two. Methods from January 2010 to December 2013, patients with patellar instability in our hospital who were first diagnosed in our hospital from January 2010 to December 2013 were followed up by telephone and by appointment. Comprehensive screening of physical examination and imaging findings, CT examination of the affected and healthy knee joints were carried out, and the detailed history of the patients was obtained, and the data of the examination were analyzed synthetically, and the injury mechanism of the patients was analyzed. The distribution of left and right sides of injured joints was compared to evaluate the value of TT-TG spacing in the diagnosis of unilateral recurrent patellar instability. Results 34 patients, male 7 and female 27, aged 14 to 31 years, had patella instability in left knee joint in 13 cases and patellar instability in right knee joint in 21 cases. The direct cause of the first dislocation in 53% of the patients was that the distance of TT-TG was (16.47 卤3.87) mm in the injured side and (15.61 卤3.52) mm in the healthy side. There was no significant difference between the two groups (P0.05). Conclusion the distance between TT-TG and TT-TG is a high risk factor for patellar instability. The distance of TT-TG in the affected side is (16.47 卤3.87) mm and (15.61 卤3.52) mm in the patients with unilateral recurrent patellar instability. There is no significant difference between the two groups (P0.05). But the knee joint of the healthy side has the tendency of patellar instability, and with the prolongation of the course of disease, this trend is more obvious. In clinical work, the evaluation parameters should be comprehensively analyzed in order to make sure the diagnosis of patellar instability, and more research should be done in exploring a more specific evaluation method for patellar instability.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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