Weight-bearing And Non-weight-bearing X-ray Within The Clinical Significance Of Early Diagnosis Of Knee Varus

ObjectiveMR examination by degeneration of the knee were evaluated to explore the knee and lower extremity weight-bearing non-weight-bearing mechanical axis of the X-ray measurements combined with degenerative osteoarthritis of the knee for the clinical significance of early diagnosis occurred within varus knee.Material and MethodsCollected from July2011to July2013due to degenerative knee osteoarthritis symptoms in patients at our hospital, performed standing full-length X-ray photography of lower limbs and ipsilateral knee supine anteroposterior X-ray photography, respectively measuring the ipsilateral knee weight-bearing and non-weight-bearing tibiofemoral angle, parallel ipsilateral knee MR examination, namely the articular cartilage, meniscus and ligament degeneration evaluated.In this study, Brouwer et al[1] measurements on the knee X-ray based measurements tibiofemoral angle; tibiofemoral angle<182°of varus,182°-184°is normal,>184°of knee valgus.Select one of the non-weight-bearing knee varus-negative diagnosis, and the weight-bearing knee varus-positive diagnosis of60patients, a sample group (non-weight-bearing knee varus false-negative group). Select the non-weight-bearing knee varus-negative diagnosis, and weight-bearing position within the knee turned negative diagnosis60patients as a control group (varus true-negative group).Which the sample group16males and44females, aged40-70years old; left knee31cases,29cases of the right knee. The control group37males and23females; aged40-70years old; left knee in28cases,32cases of the right knee.Two groups of patients had no previous history of knee surgery, no lower extremity fractures, inflammation, cancer, metabolic bone disease or congenital diseases.1. Sample group (non-weight-bearing knee varus false negative group) and the control group of patients, a total of120cases, more weight-bearing and non-weight-bearing position difference tibiofemoral angle between the two groups were compared using paired t test mean and Pearson correlation analysis. 2. Analysis of non-weight-bearing false negative occurs varus medial meniscus for the occurrence and severity of the impact, using Mann-Whitney U test.3. The analysis of non-weight-bearing false negative for medial tibiofemoral articular cartilage injury occurrence and severity of impact occurred varus, using the chi-square test.4. Analysis of non-weight-bearing false negative for medial collateral ligament injury occurrence and severity of impact occurred varus, using the chi-square test. Analysis of the same patient weight-bearing and non-weight-bearing tibiofemoral angle difference between the absolute value of the correlation with the degree of medial collateral ligament injury, using Pearson correlation analysis.Result1. The sample group and the control group weight-bearing tibiofemoral angle (181.560+1.104) were less than non-weight-bearing tibiofemoral angle (182.888+0.522), and both were positively correlated (r=0.482, P<0.01).2. The non-weight-bearing knee varus medial meniscus incidence of false-negative group:anterior horn of83.3%(50/60), the body of75.0%(45/60), the angle of88.3%(53/60). Medial meniscus injury occurred in the control group was:21.7%in the anterior horn (13/60), the body of28.3%(17/60), the angle of33.3%(20/60), the incidence of degenerative groups, the differences were statistically significant. Varus non-weight-bearing knee prosthesis negative medial meniscus anterior horn (x2=57.638, P=0.000), body (x2=59.244, P=0.000), posterior horn (x2=48.884, P=0.000) in the incidence and severity higher.3. The non-weight-bearing knee varus false-negative group medial tibiofemoral articular cartilage degeneration rate was96.7%(58/60); occurred in the control group medial tibiofemoral articular cartilage degeneration was61.7%(37/60). Two medial tibiofemoral articular cartilage degeneration incidence, were statistically significant (x2=77.054, P=0.000). Medial articular cartilage injury in non-weight-bearing knee varus tibiofemoral false-negative group the incidence and severity of the control group.4. The non-weight-bearing knee varus false negative group medial collateral ligament degeneration was66.7%(40/60); control group tibiofemoral articular cartilage degeneration medial incidence of18.3%(11/60). Two medial collateral ligament degeneration incidence, were statistically significant(x2=33.004, P=0.000). The incidence of non-weight-bearing knee varus false-negative group medial collateral ligament degeneration and severity higher. Same patient weight-bearing positively correlated with the absolute level of the medial collateral ligament of non-weight-bearing tibiofemoral angle was poor and injury (r=0.368, P=0.000).ConclusionOf weight-bearing and non-weight-bearing imaging combined with early detection of non-weight-bearing knee varus false negative patients for early diagnosis and treatment of knee osteoarthritis play a very important role.