Predictive Value of Tibial Tuberosity-trochlear Groove Distance for Patellar Instability
Objective To investigate the predictive value of tibial tuberosity-trochlear groove distance(TT-TG)for patellar instability.Methods From January 2021 to August 2022,101 patients hospitalized in the Department of Orthopedics of our hospital due to meniscus injury or suspected knee joint pain were included in the study.The patients were divided into patellar instability group(54 patients,53.47％)and non-patellar instability group(47 patients,46.53％)according to whether patellar instability was clearly diagnosed by intraoperative arthroscopy.The basic demographic characteristics and anatomical parameters of the two groups were compared.The statistically significant indicators in the univariate analysis were substituted into the multivariate logistic regression model as independent variables for analysis.The maximum likelihood ratio forward method was used to screen out the independent predictors of patellar instability.The correlation between TT-TG distance and patellar instability was analyzed.The ROC curve of independent predictors to predict patellar instability was drawn to further analyze the predictive efficacy of independent predictors.Results The proportion of femoral anteversion angle,knee joint torsion angle,TT-TG distance,and high patella in the patellar instability group was significantly higher than that in the non-patellar instability group(P＜0.05).There was no statistically significant difference between the two groups in terms of tibial lateral rotation angle,Caton index,and pulley dysplasia(P＞0.05).Multivariate Logistic regression analysis showed that femoral anteversion angle,knee joint torsion angle and TT-TG distance were independent predictors of patellar instability(P＜0.05).For every 1 mm increase in TT-TG distance,the risk of patellar instability increased by 2.246 times(OR:3.246,95％CI:1.029-6.435,P=0.003).ROC analysis showed that the area under the curve(AUC)of femoral anteversion,knee torsion angle and TT-TG distance for predicting patellar instability were 0.834(95％CI:0.756-0.887),0.776(95％CI:0.715-0.838)and 0.811(95％CI:0.732-0.875),respectively.The best diagnostic cut-off points for predicting patellar instability were 28.5 degrees,14.1 degrees and 22.5 mm,respectively;the AUC of the combined prediction of the three was 0.928(95％CI:0.887-0.975).Conclusion Femoral anteversion angle,knee joint torsion angle,and TT-TG distance are all effective predictors of patellarinstability,and their combined prediction has the highest predictive value.
万方数据
维普
