Abstract:Objective To discuss the differences between lower limb alignment X-ray knee morphology index of adult patients with Kashin-Beck disease(KBD) and that of osteoarthritis(OA)so as to provide surgical references for orthopedic treatment of severe grade adult patients with KBD. Methods Three hundred and twenty-six digital radiography(DR) anteroposterior keen film of adult patients with KBD diagnosed by Center for Disease Control and Prevention of Gansu Province from March 2012 to September 2014 were retrospectively reviewed(as KBD group). Meanwhile, 271 DR anteroposterior keen films of OA patients diagnosed by Gansu Hospital of Traditional Chinese Medicine and Wuwei Hospital of Traditional Chinese Medicine from March 2012 to September 2014 were randomly selected as OA group. A few abnormal signs on the keen film such as sclerosis thickness of subchondral bone, amount of free bodies in joint and osteophytes were evaluated, and some biomechanics angle such as femur angle, tibial angle, femorotibial angle, joint space angle, height and width of medial and lateral condylus were also measured. Results The analysis about abnormal sign in these keen films showed that in KBD group of patients, the ratio of the knees with sclerosis thickness of subchondral bone of 182 patients(55.82%, 182/326) was 2.1-4.9 mm, the ratio of knees with 1-2 free bodies was in 171 patients(52.45%, 171/326), the ratio of knees with ≥4 osteophytes in joint was in 173 patients(53.07%, 173/326). While in OA group, the ratio of the knees with sclerosis thickness of subchondral bone of 107 patients(39.48%, 107/271) was 2.1-4.9 mm, the ratio of knees with 1-2 free bodies was in 123 patients(45.38%, 123/271), the ratio of knees with ≥4 osteophytes in joint was in 145 patients(53.50%, 145/271). The differences were statistically significant (Z=2.187, 3.503, 4.029, all P values<0.05). The morphology evaluation about these knees indicated that the joint space angle, the ratio of width to height of femur medial condyle in KBD group were more than those of OA group, the femorotibial angle was less than that of OA group. the differences were statistically significant (t=10.464, 24.174, 30.539, all P values<0.01); But compared with OA group, the femur angle, the tibial angle and the ratio of width to height of femur lateral condyle in KBD group were not statistically significant(t=0.943, 1.763, 0.551, all P values>0.05). Conclusions The lower limb alignment in both OA group and KBD group is lean to the medial condyle, but the latter is more conspicuous than the former.
陈国华,贾润慧,高长泰,廖永建. 成人大骨节病膝关节生物力学及形态学数字X线摄影评价[J]. 中华解剖与临床杂志, 2016, 21(3): 185-189.
Chen Guohua, Jia Runhui, Gao Changtai, Liao Yongjian. Digital radiography evaluation of morphology and bone biomechanics for knees of adult patients with Kashin-Beck disease. Chinese Journal of Anatomy and Clinics, 2016, 21(3): 185-189.