| Background:With the development of China's economy,the population gradually increased,patellar dislocation and patellar tissue damage caused by patellar instability in patients also gradually increased.Knee joint injuries can often lead to patellofemoral injury,causing the pain of the anterior knee,some severe cases can cause leg pain and affact stability of the knee,and even cause limb mobility disorders.If the injury can not get some effective treatment,then the knee patellofemoral joint instability will lead to articular cartilage damage accelerated,and long-term occurrence of knee osteoarthritis risk is higher.In terms of patellar dislocation,the susceptibility of the disease and the occurrence and development of the disease has a more closely linked.With the development and progress of medical science,more and more susceptibility factors have been incorporated into the evaluation system of patellar dislocation susceptibility in recent years,and some research results have been obtained,especially in imaging-related Sense of the diagnosis of factors.However,there is little research on the relationship between the combined effects of patellar dislocation predisposing factors and many susceptibility factors,and there is no scientifically effective and widelyaccepted evaluation system to assess the risk of patellar dislocation or instability.Purpose:To explore the effects of many susceptibility factors on the occurrence of patellar dislocation,the interaction between susceptibility factors and the main susceptibility factors and their effects in patients with recurrent patellar dislocation from acute primary patellar dislocation.Method:Retrospective analysis of our hospital in January 2010 to October2016 treatment in our hospital and "patellar dislocation" as the main diagnostic income of our department of 122 patients,will be divided into acute primary dislocation group(initial group): a total of 42 cases,and recurrent dislocation group(recurrent group): a total of 80 cases.Patients were collected from the knee joint of the knee joint lateral imaging data,knee MR scan and CT scan imaging data.Which patients age 16.3 ± 5.4,sex: male: 70 cases,female: 52 cases.Patients in the primary and secondary groups were measured separately.The distance between the age,sex,patellar shape,patellar height,patella tilt,trochlear shape classification,trochlear groove depth,trochlear lateral tilt angle,TT-TG distance and Q angle were collected and collected Of the data for statistical analysis.The proportion of the factors in the susceptibility factor collected was analyzed and the difference between thesusceptibility factors in the primary group and the recurrent group was compared.In addition,susceptibility factors with significant differences in the initial and relapse groups were selected for the production of the scoring system to assess the risk of patellar dislocation from primary dislocation to recurrence dislocation.Result:The age of the initial group was 17 ± 3.3 years old,and the recurrence group was 15 ± 5.2 years old,with significant difference(P <0.05).The value of Insall-Salvati was 1.30 ± 0.16 in the initial group and 1.37 ± 0.13 in the recurrence group,which was significantly different(P <0.05).The patella angle of the initial group was 17 ° ± 4.8,and the inclination angle of the patella was 20 ° ± 6.8,which was significantly different(P <0.05).The depth of the trochlear groove was 2.2 ± 0.15 mm in the initial group and 2.1 ± 0.23 mm in the recurrence group,which was statistically significant(P <0.05).The inclination angle of the outer group was 12.5%??± 0.08,and there was no significant difference between the two groups.The TT-TG distance of the initial group was 12 ± 7.4mm,and the TT-TG distance was 16 ± 8.8mm in the recurrence group.There was significant difference between the two groups(P <0.05).Q angle: 22 ° ±2.2,recurrence group: Q angle: 23 ° ± 1.5,no significant difference.The initial group: 28 males,14 females,recurrence group: 42 males and 38 females.There is no significant difference.The initial group: mildslippery dysplasia 18 people,severe trochlear dysplasia: 24 people,relapse group: mild slippery dysplasia 12,severe slippery dysplasia 68 people.With significant differences.The initial group: Wiberg ? type 18 people,Wiberg ? type 10 people,Wiberg ? type 14 people,recurrence group Wiberg I type 30 people,Wiberg type 28 people,Wiberg ? type 22 people,does not have significant difference.The proportion of susceptibility factors in the overall sample: high patella accounted for90.16%(110),patella tilt accounted for 70.49%(86),tubal dysplasia95.83%(115),tibial tubercle 75.41%(92),femoral forward(68),aged less than 16 years old: 59.01%(72),male 57.38%(70),female 42.62%(52),Wiberg type: 39.34%(48),Wiberg ? type 31.15%(38)Wiberg ? type 29.51%(36).Select the age,patellar height,patella tilt,trochlear development and tibial tubercle position of the five susceptibility factors to produce scoring system.Patients with 80 patients with relapse were analyzed for scores of susceptibility factors,of which 2 patient score 0.5 patient score1.11 patient score 2.36 patient score3.21 patient score 4.7 patient score 5.Conclusion:1.In many patellar dislocation susceptibility factors in the trochlear dysplasia for the occurrence of the role of patella is the most important.2.The age,patellar height,patella tilt,trochlear dysplasia and tibial nodular location of these five susceptibility factors in the acute primarydislocation into the recurrence of patellar dislocation has an important role in the process.3.Recurrence dislocation risk score system can effectively assess the risk of recurrence of patients with dislocation. |
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