在 Ipsilateral 中间骨关节重建后,对侧面骨不稳定的预测
Ali Asma1, Samir Sharrak1, Marcus A Shelby1
1Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
The American journal of sports medicine
|January 21, 2026
概括
患有ipsilateral皮带不稳定的患者面临着相反侧面不稳定的显著风险. 关键预测因素包括骨不成熟,关节过度移动,反复发生的脱位,三角膜发育不良和大腿.
科学领域:
- 整形外科 整形外科 整形外科
- 运动医学 运动医学
- 生物机械工程 生物机械工程
背景情况:
- 双边皮带不稳定性影响10-16%的患者.
- 对逆侧带不稳定的风险因素是未知的.
- 在双边病例中指出了低于最佳的结果.
研究的目的:
- 识别未来的逆侧骨不稳定性的风险因素.
- 开发一个预测模型,用于对侧面状骨的不稳定性.
主要方法:
- 380个MPFL重建 (2012-2022) 的回顾性案例系列 (证据水平,4).
- 评估了骨成熟度,普遍的关节高移动性 (比顿分数≥5),以及脱位的复发.
- 评估了三角膜深度,Caton-Deschamps指数,TT-TG距离和骨倾斜的两侧膝盖MRI.
- 使用多变量后勤回归来识别风险因素并开发预测模型.
主要成果:
- 34.2%的患者出现了对侧面乳头不稳定.
- 确定了独立的预测因素:骨不成熟 (OR 1.90),普遍的关节高移动性 (OR 2.80),反复出现的两侧不稳定性 (OR 2.00),三角形发育不良 (OR 1.90) 和大腿骨高 (OR 1.80).
- 预测风险范围从9.2% (没有风险因素) 到77.8% (所有5个风险因素).
结论:
- 骨不成熟,反复出现的两侧侧部不稳定性,普遍的关节多动性,三侧部发育不良和部高部预测对侧部不稳定性.
- 简化模型可以根据这些因素估计抵押品风险.
- 这些知识有助于管理患有单边带不稳定的患者.
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