[1]王清玉△ 王佳佳 李良华 韩大为 王和鸣.膝关节骨关节炎不同分期与膝关节轴线角的相关性分析[J].中国中医骨伤科杂志,2016,24(11):24-29.
　WANG Qingyu WANG Jiajia LI Lianghua HAN Dawei WANG Heming.Correlation Analysis between Knee Osteoarthritis in Different Stages and Knee Joint Axis Angle[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(11):24-29.
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膝关节骨关节炎不同分期与膝关节轴线角的相关性分析
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年11期
页码:
24-29
栏目:
临床研究
出版日期:
2016-11-01

文章信息/Info

Title:
Correlation Analysis between Knee Osteoarthritis in Different Stages and Knee Joint Axis Angle
文章编号:
1005-0205(2016)08-0024-06
作者:
王清玉1△ 王佳佳1 李良华1 韩大为1 王和鸣1
1.福建中医药大学附属人民医院(福州,350004)
△.通信作者 E-mail:453715383@qq.com
Author(s):
WANG Qingyu1△ WANG Jiajia1 LI Lianghua1 HAN Dawei1 WANG Heming1
1.The People's Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China.
关键词:
膝关节;  骨关节炎;  轴线角
Keywords:
knee;  osteoarthritis;  joint axis angle
分类号:
R684.3
文献标志码:
A
摘要:
目的:了解膝关节骨关节炎(KOA)不同分期与膝关节轴线角的相关性。方法:按照标准纳入研究对象796例中,健康正常人100例,影像学符合Kellgren/Lawrence(K/L)Ⅰ级的患者237例,Ⅱ级的患者142例,Ⅲ级的患者164例,Ⅳ级的患者153例。将健康正常人作为对照组,将K/L分级的Ⅰ～Ⅳ级分为一期组、二期组、三期组、四期组,按随机序列表方法,随机选取各组50例,男女各25例,共纳入250例。对正常健康人单侧和KOA拍摄患侧下肢全长正侧位X线片,通过在下肢全长X线片确定下肢轴线,分别测量股骨胫骨角、胫骨平台角、股骨下角、胫骨上角、关节间隙角、股骨髁干角并做比较。结果:经Spearman等级相关分析,股骨胫骨角、关节间隙角、胫骨平台角、胫骨上角与KOA K/L分期相关,且差异均有统计学意义(P<0.01); 股骨髁干角与KOA K/L分期差异无统计学意义(P=0.756); 胫骨平台角与KOA K/L分期相关,差异有统计学意义(P<0.01)。结论:1)冠状位轴线角中关节间隙角、股骨下角、胫骨上角、股骨胫骨角与KOA严重程度相关; 2)矢状面轴线角中股骨髁干角与KOA无相关性; 胫骨平台角与KOA严重程度相关。
Abstract:
Objective:To identify the correlation between knee joint axis angle and knee osteoarthritis in different stages.Methods:According to the standard of 796 cases,100 cases of healthy people,237 patients with K/L I grade,142 patients with grade Ⅱ,164 patients with grade Ⅲ,153 patients with grade Ⅳ.Healthy people as the control group,the patients of K/L I-Ⅳ level were divided into stage I group,stage Ⅱ group,stage Ⅲ group and stage Ⅳ group.According to the random sequence table,50 cases of each group were randomly selected,with a gender ratio of half to half.A total of 250 cases were included.All the people took the lower limb X ray to determine the axis of the lower extremity.Measurements were made on the femoraltibial angle,tibial plateau angle,lower femoral angle,upper tibial angle,joint space angle and femoral condyle-shaft angle,and a comparison was made.Results:Spearman grade correlation analysis showed that the femoraltibial angle,joint space angle,tibial plateau angle and upper tibial angle were positively correlated with K/L KOA stage,and all had significant difference(P<0.01).There was no significant difference between the femoral condyle-shaft angle and K/L KOA stage(P=0.756>0.05).The tibial plateau angle was negatively correlated with K/L KOA stage,and the difference was statistically significant(P<0.01).Conclusion:1)The joint space angle,lower femoral angle,upper tibial angle and the femoraltibial angle were positively correlated with the severity of KOA.2)In the sagittal axis,there was no correlation between the femoral condyle-shaft angle and KOA,and the tibial plateau angle was negatively correlated with the severity of KOA.

参考文献/References:

[1] 顾明士,张申岳,王萍,等.中老年人膝骨关节炎患病趋势十年前后对照分析[J].上海医药,2013,34(4):57-59.
[2] Block JA,Shakoor N.Lower limb osteoarthritis:biomechanical alterations and implic-ations for therapy [J].Curr Opin Rheumatol,2010,22(5):544-550
[3] Moreland JR,Bassett LW,Hanker GJ.Radiograghic analysis of the axial alignmen-t of the lower extremity[J].J Bone Joint Surg(Am),1987,69:745-749.
[4] Erme Cullu E,Ozkan I,Alparslan B.Tibial slope(in Turkish)[J].Arthroplasty Arthrosc Surg.1999,10:174-178.
[5] Hashemi J,Chandrashekar N,Gill B,et al.The geometry of the tibial plateau and its influence on the biomechanics ofthe tibiofemoral joint.Bone Joint Surg Am,2008,2724:90.
[6] Tanamas S,Hanna FS,Cicuttini FM,et al.Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review [J].Arthritis Rheum,2009,61(4):459-467.
[7] 韩旭东.胫骨内侧平台后倾角放射学测量评价及其与膝骨关节炎的关系[D].广州:广州中医药大学,2011.
[8] 褚立希,王锋.膝骨关节炎X片生物力学及形态学测量分析[J].中西医结合学报,2004,2(6):432-434.
[9] 马玉峰,王庆甫,陈兆军,等.膝关节骨性关节炎X线测量与WOMAC评分的多重线性回归分析[J].中国骨伤,2012,25(5):373-376.
[10] 夏亚一,孙正义,黑坂昌弘,等.下肢力学轴线改变与膝关节骨关节炎的关系[J].中国临床康复,2003,7(20):2832-2833.
[11] 叶永平.膝骨关节炎病因、X线片及临床表现分析[J].临床骨科杂志,2000,3(3):169-172
[12] 李仕臣,王文革,刘琦.膝关节骨关节炎和胫股解剖轴线的相关性研究[J].中国药物与临床,2011,11(3):327-328.
[13] 蔡余力,王少山.膝关节骨性关节炎的X线测量与分析[J].中国中西医结合影像学杂志,2006,5(6):358-361.
[14] 刘源.膝症状性骨关节病320例X线分析[J].中华风湿病学杂志,1997,1(1):14.
[15] Terauchi M,Shirakura K,Katryama M.The influence of osteoporosis on varus osteoarthritis of the knee[J].Journal of bone and joint surgery-british volume,1998,(03):432-436.
[16] 杨峰.采用槽氏钢板做胫骨高位截骨术治疗内翻型膝关节骨性关节炎[J].中国矫形外科杂志,2001,8(2):118-120.

备注/Memo

备注/Memo:
基金项目:福建中医药大学校管课题(XB2014010)
更新日期/Last Update: 2016-11-15