| BACKGROUND:Patellar dislocation is more common in young female patients,It is a common cause of knee pain in teenagers,For the treatment of the patellar dislocation,Clinical treatment methods are divided into surgical treatment and conservative treatment,However,surgical treatment can achieve good prognostic results relative to conservative treatment,Most surgical patients with postoperative knee function recovery can return to normal pre-injury levels,Therefore,the current clinical treatment of patella dislocation is more selected for surgical treatment,The initial surgical treatment is generally made of medial patellar and femoral ligament reconstruction,However,some patients still undergo dislocation after medial patellar femoral ligament reconstruction,As studies of patellofemoral joint disease have increased,The anatomical factors affecting the stability of the patellar femoral joint are gradually recognized,The recurrence of the patient after surgery may result from a failure to correct these risk factors,Combined osteotomy is required,To change the abnormal bone anatomy and to correct the bone deformities,Reduce the likelihood of another dislocation of the patella after surgery,This requires the clinicians before developing a surgical treatment plan,According to the patient’s imaging data and specialist physical examination,The factors affecting the stability of the patellofemoral joint were evaluated,To provide a reference for the choice of surgical options,At present,osteotomy is used in osteotomy,However,the preoperative evaluation indicators for the tibial nodule osteotomy are still relatively lacking.OBJECTIVE: Introducing a new evaluation index affecting the stability of patellar femoral joint: tibia nodule torsion angle,measure and analyze the correlation between tibia nodule torsion angle and patellar dislocation,study the diagnosis and clinical practical value of the evaluation of tibia nodule torsion angle and TT-TG distance（tibia nodule-femoral slide workshop distance）and patellar tilt angle.METHODS : A total of 42 patients with patellar dislocation were collected from the Department of Orthopaedic Sports Trauma and Arthroscopic Surgery of the First Affiliated Hospital of Anhui Medical University from January to August 2020,and 46 patients from the control group.The torsion Angle of tibial nodule,TT-TG distance and patellar inclination Angle of the two groups were measured under CT respectively,and the three parameters of the data of the two groups were statistically analyzed.To analyze the correlation between tibial nodule torsion Angle and patellar dislocation and evaluate the clinical application value of tibial nodule torsion Angle.RESULTS:The torsion angle of tibial nodules was statistically different between patients and controls.The torsion angle can be used as a risk factor for patella nodular dislocation compared to two other parameters,and has some diagnostic ability for patellar dislocation（AUC=0.923）.DISCUSSION: With the in-depth study of patellofemoral joint disease,The current surgical mode of patellar dislocation has changed dramatically,There are more and more procedures available to surgeons,Surgical treatment for patellar dislocation has also developed to use a combination of multiple surgical modalities,To allow the patella dislocation patients to achieve the best therapeutic results,The surgeon should perform a preoperative assessment of the anatomical structure and injury characteristics of each individual patient,Develop the optimal combination of surgical methods suitable for each patient’s own condition,In order to achieve the relatively best prognostic effect,This study demonstrates a close correlation between the torsion angle of tibial nodules and patellar dislocation,And has a certain diagnostic ability to the patella dislocation,It is distinguished by a threshold of 20.86°,Statistical analysis of the torsion angle of tibial nodules can be included in the stability of the patellar femoral joint compared to two other parameters,Patient with preoperative evaluation that can be used for,Provide a reference for the choice of patella dislocation surgery mode. |
