Knee joint changes in patients with neglected developmental hip dysplasia: A prospective case-control study
Knee joint changes in patients with neglected developmental hip dysplasia: A prospective case-control study
复制标题
被忽视的发育性髋关节发育不良患者的膝关节变化：一项前瞻性病例对照研究
DOI：
10.1016/j.knee.2014.08.012
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发表时间：
2014-12-01
期刊：
影响因子：
1.9
通讯作者：
Li, Lianyong
中科院分区：
文献类型：
--
作者：
Li, Qiwei;Kadhim, Muayad;Li, Lianyong
背景：很少有报道可描述髋关节（DDH）被忽视的发育发育不良的膝关节变化。这项研究的目的是评估被忽视的DDH的成年人的膝关节的射线照相形态。 23例患者单侧，14例患者被忽略了双侧DDH。招募了37个健康个体，形成了一个匹配的对照组。检查了三组膝关节：受影响的膝盖（在被忽视的DDH的同一侧），未受影响的膝盖（单方面参与患者被忽视的DDH对侧）和对照膝盖。在冠状和矢状平面中测量了一系列膝关节的放射线学参数，并在患者和正常对照之间进行比较。分辨率：在冠状平面，受影响的膝盖的外围角度增加了与内侧股骨高度相关的外围角度增加与对照膝盖相比，condyle，股骨外侧con的高度降低，股骨外侧远端降低。在矢状平面中，受影响的膝盖的股骨远端和近端胫骨关节都在后角下降。此外，与对照膝关节相比，未受影响的膝盖还会发生放射线学变化。结论：被忽视的DDH患者可能会出现两个膝关节的变化。这些变化应在手术期间对髋关节，股骨和膝盖进行预防潜在的并发症。
Background: Few reports are available describing knee changes in neglected developmental dysplasia of the hip (DDH). The purpose of this study was to assess the radiographic morphology of knee joints in adults with neglected DDH.Methods: Thirty-seven patients (35 females and two males) with neglected DDH were prospectively recruited with an average age of 32.6 years. Twenty-three patients had unilateral and 14 patients had bilateral neglected DDH. Thirty-seven healthy individuals were recruited to form a matched control group. Three groups of knee joints were examined: affected knees (on the same side of the neglected DDH), unaffected knees (contralateral to the neglected DDH in patients with unilateral involvement), and control knees. A series of radiographic parameters of the knee joint were measured in the coronal and sagittal plane, and they were compared between patients and normal controls.Results: In the coronal plane, the affected knees had increased valgus angulation related to increased height of the medial femoral condyle, decreased height of the lateral femoral condyle and decreased lateral distal femoral angle compared to control knees. In the sagittal plane, both distal femoral and proximal tibial joints of the affected knees developed a decrease in posterior angles. Additionally, the unaffected knees also developed radiographic changes compared to control knees.Conclusions: Patients with neglected DDH may develop changes in both knee joints. These changes should be considered during surgery to the hip, femur and knee to prevent potential complications.Level of evidence: Level 2. (C) 2014 Elsevier B.V. All rights reserved.