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目的评价改进后的屈膝25°髌骨轴位 X 线摄片及多种测量法的临床意义。方法用特制髌骨轴位摄影架摄片,测量无症状者(正常人)30名作为对照组;有前膝痛(AKP),经轴位摄片发现髌骨排列异常者154例。测量沟角(SA)、适合角(CA)、髌骨侧方移位度(L5)、外侧髌骨角(LPFA)、髌骨指数(PET)、髌骨横向移位距离(LPD)。结果 2组各参数平均值分别为:对照组:SA137.38°,CA-10.73°,LS 10.49%,LPFA 13.70°,PFI 0.48,LPD 0.45 mm;AKP 组:SA 142.38°,CA0.71°,LS 19.68%,LPFA 12.12°,PFI 1.13,LPD 0.42 mm。2组各参数比较,t 值分别为9.36、10.16、4.18、7.98、0.82、12.29,除 LPD 的 P 值>0.05外,其他各项 P 值均<0.01。反映髌骨排列异常的敏感性以 PFI、CA、LS、LPFA、LPD 较明显,分别为71.66%、63.33%、56.66%、21.60%、16.66%。结论采用改进后的屈膝25°髌骨轴位摄片,可使摄片成功率及清晰度明显提高,使划线测量简易准确,得出的相关资料更为可靠。
Objective To evaluate the clinical significance of modified 25 ° patellar axis radiographs and various measurements. Methods A total of 30 patients with asymptomatic (normal) as control group were examined with a special patellar axial photographic camera. 154 patients with anterior knee pain (AKP) and abnormal patellar alignment were found by axial radiography. SA, CA, L5, LPFA, Patellar index (PET), lateral displacement of the patella (LPD) were measured. Results The mean values of the two groups were as follows: control group: SA137.38 °, CA-10.73 °, LS 10.49%, LPFA 13.70 °, PFI 0.48, LPD 0.45 mm; AKP group SA 142.38 °, CA0.71 °, LS 19.68%, LPFA 12.12 °, PFI 1.13, LPD 0.42 mm. The comparison of the two groups of parameters, t values were 9.36,10.16,4.18,7.98,0.82,12.29, except LPD P value> 0.05, the other P values were <0.01. The sensitivity of abnormal patellar alignment was 71.66%, 63.33%, 56.66%, 21.60% and 16.66% with PFI, CA, LS, LPFA and LPD respectively. Conclusions The improved 25 ° patellar axis radiography with knee flexion significantly improves the radiographic success rate and sharpness, making the measurement of streaks easier and more accurate. The relevant data obtained are more reliable.