摘要
[目的]通过比较膝关节骨性关节炎(knee osteoarthritis,KOA)患者与正常人的矢状面相关参数,探讨KOA患者矢状面形态异常及其临床意义。[方法]研究收集正常人64例和KOA患者62例的站立位全脊柱侧位X线片并测量下列参数:(1)脊柱矢状面参数:脊柱骶骨角(spinal-sacral angle,SSA)、脊柱前倾角(spinal tilt,ST)、腰椎前凸角(lumbar lordosis,LL);(2)骨盆及相关下肢矢状面参数:骨盆投射角(pelvic incidence,PI)、骶骨倾斜角(sacral slope,SS)、骨盆倾斜角(pelvic tilt,PT)、骶骨股骨角(sacrum femoral angle,SFA)、骨盆股骨角(pelvic femoral angle,PFA);股骨倾斜角(femoral inclination,FI)。采用独立样本t检验分析组间各矢状面参数间的差异性,同时应用Pearson相关性分析KOA组各个参数相关性。[结果]两组间年龄、性别分布差异无统计学意义。KOA组FI(11.0±5.2)较正常对照组增大,但SFA(43.3±11.8)和PFA(2.0±9.2)值较正常对照组(SFA:52.0±8.5;PFA:8.8±7.9)减小,且差异均有统计学意义(P<0.05);此外KOA组ST(88.6±4.2)值较正常对照组(93.0±3.4)减小,且差异有统计学意义(P<0.05);而SS、PT和PI值与正常对照组相近,且差异无统计学意义(P>0.05)。KOA组SFA与PFA存在明显正相关(r=0.494),而与FI则存在明显负相关(r=-0.668);PFA与FI存在明显负相关(r=-0.586)。[结论]KOA患者膝关节明显屈曲,导致其脊柱和骨盆前倾。KOA患者的这些矢状面形态在行全膝关节置换术设计时需要加以考虑。
[Objective] To document sagittal morphological abnormalities and their clinical relevance in patients with knee osteoarthritis（ KOA） in comparison with a healthy population. [Methods] Standing lateral spinal- pelvic radiographs were collected from 64 healthy people and 62 patients with KOA. Measurements of the following parameters were performed by two independent observers：（ 1） spinal sagittal parameters： spinal- sacral angle,spinal tilt（ ST）,and lumbar lordosis; and（ 2）pelvic and lower leg sagittal parameters： pelvic incidence（ PI）,sacral slope,pelvic tilt,sacral femoral angle（ SFA）,pelvic femoral angle（ PFA）,and femur inclination（ FI）. Comparisons between the two independent groups were performed by using the Student t tests,and the correlation between the sagittal parameters in the KOA group were determined by using the Pearson test. [Results] No statistically significant differences in age and sex distributions were observed between the groups. The patients with KOA showed a significantly higher FI（ 11. 0 ± 5. 2） but smaller SFA（ 43. 3 ± 11. 8） and PFA（ 2. 0 ± 9. 2） than in the healthy controls（ P〈0. 05）. In addition,the ST（ 88. 6 ± 4. 2） in the patients with KOA was significantly smaller than that in the healthy controls（ P〈0. 05）. Significant correlation was observed between SFA and PFA（ r = 0. 494）,between SFA and FI（ r =- 0. 668）,and between PFA and FI（ r =- 0. 586） in the patients with KOA. [Conclusion] The significant forward inclinations of the spine and pelvis that were observed in the KOA patients might have been due to knee flexion. Abnormal sagittal spinal- pelvic alignment in patients with KOA should be considered when planning for total knee arthroplasty.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第9期784-789,共6页
Orthopedic Journal of China
基金
江苏省“六大人才高峰”第十批高层次人才项目(编号:WSW-002)
南京市医学发展项目杰出青年基金(编号:JQX13008)
南京市医学发展项目一般性课题(编号:YKK12081)
关键词
膝骨性关节炎
矢状面平衡
代偿
临床意义
knee osteoarthritis sagittal alignment compensation clinical significance
