髌股关节病中髌骨外侧骨赘形成的相关危险因素分析

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1645 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的分析髌股关节病中髌骨外侧缘骨赘形成的相关危险因素。方法回顾分析2015年12月至2019年12月由北京大学第三医院同一医生手术的连续75例符合纳入和排除标准的髌股关节病患者的临床资料。其中男21例，女54例；平均身体质量指数(body mass index，BMI)为(25.3±2.9) kg/m2；年龄28~78岁，平均(55.1±12.2)岁。运用独立样本t检验、χ²检验和秩和检验对相关危险因素进行单因素分析，相关危险因素包括年龄、病程、性别、BMI、髌骨软骨损伤等级、内外侧间室损伤等级和髌骨外侧倾斜角(patellar tilting angle，PTA)。本研究运用Outer-bridge分级评估髌骨软骨损伤等级和内外侧间室损伤等级，运用PTA评估髌骨排列异常。本研究将单因素分析结果P≤0.1的相关危险因素纳入多因素分析，运用Logistic回归进行多因素分析。结果单因素分析中，有骨赘组和无骨赘组相比，年龄(t＝－2.026，P＝0.046)、髌骨软骨损伤(Z＝－2.651，P＝0.008)和内侧间室损伤程度(Z＝－2.110，P＝0.035)，差异具有统计学意义。多因素分析中，髌骨软骨损伤可能为髌骨外侧骨赘的独立危险因素(OR=2.093，95%CI=1.188~3.687，P＝0.011)。结论髌骨外侧缘有骨赘者年龄更大，髌骨软骨损伤程度和内侧间室损伤程度更加严重。髌骨软骨损伤可能是髌骨外侧骨赘存在的独立危险因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	曹健夫
	蔡雨琦
	刘颖
	崔国庆
	杨渝平

关键词 ：髌股关节病, 骨赘, X线, 危险因素

Abstract：Objective To analyze the risk factors of osteophyte formation in patellofemoral joint disease.Methods The clinical data of 75 patients underwent patellofemoral arthropathy and met the inclusion and exclusion criteria were retrospectively analyzed.The patients were operated by the same doctor in Peking University Third Hospital from December 2015 to December 2019.There were 21 males and 54 females，with an average BMI of (25.3±2.9) and an average age of(55.1±12.2) years old ranging from 28 to 78 years old.Independent sample t test，chi-square test and rank sum test were used for single factor analysis of risk factors，including age，course of disease，sex，BMI，patellar cartilage injury grade，medial and lateral compartment injury grade and patellar tilting angle(PTA).In this study，patellar cartilage injury grade and medial or lateral compartment injury grade were evaluated by outer-bridge grade，and patellar alignment abnormality was evaluated by PTA.In this study，the related risk factors of P≤0.1 were included in the multivariate analysis，and logistic regression was used for multifactor analysis. Results In univariate analysis，there were statistically significant differences in age(t＝－2.026，P＝0.046)，patellar cartilage injury(Z＝－2.651，P＝0.008) and medial compartment injury degree(Z＝－2.110，P＝0.035) between the osteophyte group and the non-osteophyte group.In multivariate analysis，patellar cartilage injury was a possible independent risk factor for osteophytes on the lateral edge of the patella(OR=2.093，95%CI：1.188~3.687，P＝0.011).Conclusion The patients with osteophytes at the lateral margin of patella are older，and the injury degree of patella cartilage and medial compartment is more serious.The injury of patella cartilage is a possible independent risk factor for osteophytes at the lateral margin of patella.

Key words： patellofemoral arthropathy osteophyte X-ray risk factors

通讯作者: 杨渝平

作者简介: 曹健夫(2000－ )，男，本科在读，首都医科大学附属复兴医院，cjf20000628@163.com

引用本文:

曹健夫，蔡雨琦，刘颖，崔国庆，杨渝平. 髌股关节病中髌骨外侧骨赘形成的相关危险因素分析[J]. 实用骨科杂志, 2023, 29(7): 588-.
Cao Jianfu，Cai Yuqi，Liu Ying，Cui Guoqing，Yang Yuping. Risk Factors of Lateral Patellar Osteophyte Formation in Patellofemoral Arthropathy. sygkzz, 2023, 29(7): 588-.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I7/588

［1］孔庆波，李宝林，陈福来，等.X线片测量髌骨外倾角在髌股关节病诊断中的应用［J］.中华关节外科杂志(电子版)，2018，12(3)：421-423.
［2］Sherman SL，Plackis AC，Nuelle CW.Patellofemoral anatomy and biomechanics［J］.Clin Sports Med，2014，33(3)：389-401.
［3］Chang CB，Seong SC，Kim TK.Evaluations of radiographic joint space—do they adequately predict cartilage conditions in the patellofemoral joint of the patients undergoing total knee arthroplasty for advanced knee osteoarthritis?［J］.Osteoarthritis Cartilage，2008，16(10)：1160-1166.
［4］Huang W，Ong TY，Fu SC，et al.Prevalence of patellofemoral joint osteoarthritis after anterior cruciate ligament injury and associated risk factors：A systematic review［J］.J Orthop Translat，2019(22)：14-25.
［5］Pengas I，Nash W，Assiotis A，et al.The effects of knee meniscectomy on the development of osteoarthritis in the patellofemoral joint 40years following meniscectomy［J］.Eur J Orthop Surg Traumatol，2019，29(8)：1705-1708.
［6］Boegard T，Rudling O，Petersson IF，et al.Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the patellofemoral joint［J］.Ann Rheum Dis，1998，57(7)：395-400.
［7］Wang CL，Chen JB，Li T.Outcome and experience of arthroscopic lateral retinacular release combined with lateral patelloplasty in the management of excessive lateral pressure syndrome［J］.J Orthop Surg Res，2021，16(1)：80.
［8］Qiu Y，Lin C，Liu Q，et al.Imaging features in incident radiographic patellofemoral osteoarthritis：the Beijing Shunyi osteoarthritis(BJS) study［J］.BMC Musculoskelet Disord，2019，20(1)：359.
［9］Haj-Mirzaian A，Guermazi A，Pishgar F，et al.Association of patella alta with worsening of patellofemoral osteoarthritis-related structural damage：data from the osteoarthritis initiative［J］.Osteoarthritis Cartilage，2019，27(2)：278-285.
［10］Fones L，Jimenez AE，Cheng C，et al.Trochlear dysplasia as shown by increased sulcus angle is associated with osteochondral damage in patients with patellar instability［J］.Arthroscopy，2021，37(12)：3469-3476.
［11］Altman RD，Gold GE.Atlas of individual radiographic features in osteoarthritis，revised［J］.Osteoarthritis Cartilage，2007，15(Suppl A)：A1-56.
［12］Nagaosa Y，Mateus M，Hassan B，et al.Development of a logically devised line drawing atlas for grading of knee osteoarthritis［J］.Ann Rheum Dis，2000，59(8)：587-595.
［13］Gursoy M，Mete B D，Dag F，et al.The distribution of loose bodies determined on knee magnetic resonance imaging：joint compartments，recesses and bursae including arthroscopic blind spots［J］.Acta Radiol，2019，60(10)：1286-1293.
［14］Slattery C，Kweon CY.Classifications in brief：outerbridge classification of chondral lesions［J］.Clin Orthop Relat Res，2018，476(10)：2101-2104.
［15］杨渝平，陈泓宇，赵静文，等.两种外侧支持带松解法治疗髌骨外侧过度挤压综合征的回顾性对照研究［J］.中华外科杂志，2021，59(9)：757-763.
［16］Ferrari MB，Sanchez G，Chahla J，et al.Arthroscopic patellar lateral facetectomy［J］.Arthrosc Tech，2017，6(2)：e357-e362.
［17］Zhao C，Gao X，Liu Q，et al.Associations of trochlea morphology and patellofemoral alignment with prevalent radiographic patellofemoral osteoarthritis［J］.Osteoarthritis Cartilage，2020，28(6)：824-830.
［18］HafeziNejad N，Demehri S，Guermazi A，et al.Osteoarthritis year in review 2017：updates on imaging advancements［J］.Osteoarthritis Cartilage，2018，26(3)：341-349.
［19］Yang YP，Ling YD，Pang CN，etc.Novel method for diagnosing lateral patellar compression syndrome using X-ray：a retrospective case-control study［J］.Ann Transl Med，2021，9(6)：445.
［20］Nagaosa Y，Lanyon P，Doherty M.Characterisation of size and direction of osteophyte in knee osteoarthritis：a radiographic stud［J］.Ann Rheum Dis，2002，61(4)：319324.
［21］Li Z，Liu Q，Zhao C，et al.High prevalence of patellofemoral osteoarthritis in China：a multi-center population-based osteoarthritis study［J］.Clin Rheumatol，2020，39(12)：3615-3623.
［22］Landsmeer M，Vos BCD，Plas PVD，et al.Effect of weight change on progression of knee OA structural features assessed by MRI in overweight and obese women［J］.Osteoarthritis Cartilage，2018，26(12)：1666-1674.
［23］Gersing AS，Schwaiger BJ，Nevitt MC，et al.Is weight loss associated with less progression of Changes in knee articular cartilage among obese and overweight patients as assessed with MR imaging over 48 months? data from the osteoarthritis initiative［J］.Radiology，2017，284(2)：508-520.
［24］Montserrat F，AlentornGeli E，León V，et al.Treatment of isolated patellofemoral osteoarthritis with lateral facetectomy plus insall’s realignment procedure：Long-term followup［J］.Knee Surg Sports Traumatol Arthrosc，2013，21(11)：2572-2577.
［25］Van Middelkoop M，Bennell KL，Callaghan MJ，et al.International patellofemoral osteoarthritis consortium：Consensus statement on the diagnosis，burden，outcome measures，prognosis，risk factors and treatment［J］.Semin Arthritis Rheum，2018，47(5)：666-675.
［26］Kumm J，Turkiewicz A，Zhang F，et al.Structural abnormalities detected by knee magnetic resonance imaging are common in middle-aged subjects with and without risk factors for osteoarthritis［J］.Acta Orthop，2018，89(5)：535-540.
［27］陈后煌，邵翔，马玉环，等.骨关节炎骨赘形成的机制探讨［J］.风湿病与关节炎，2016，5(5)：36-38.
［28］Cheng C，Gao S，Lei G.Association of osteopontin with osteoarthritis［J］.Rheumatol Int，2014，34(12)：1627-1631.
［29］Retraction.Effects of osteopontin on expression of IL-6 and IL-8 inflammatory factors in human knee osteoarthritis chondrocytes［J］.Cell Biochem Biophys，2014，70(1)：703.