Assessment of Patellofemoral Joint Congruence in Normal Young Adults

正常成人膝關節吻合度之研究

江振崑(Junn-Kuen Chiang) ； 林永福(Yeong-Fwu Lin) ； 楊卿潔(Ching-Zye Yang) ； 楊長彬(Charne-Bin Yang) ； 鐘仁文(Jen-Wen Chung) ； 鄭國安(Quo-An Cheng)

《Journal of Orthopaedic Surgery Taiwan》 9卷4期 (1992/12) Pp. 183-192

摘要

在骨科的門診中，經常有許多年經的病忠主訴前膝部疼痛，走路時有隱定感。這些病患既無膝部傷的病史，X-光片上無明顯的骨骼病變，因此前膝部疼痛的治療一直困擾著病人及骨科醫師，一直到1960年代的未期，經多位學者，例如Laurin, Merchant, Hughston等人的研究，才了解膝部疼痛症的根本原因，仍因髕骨排列不正，在膝關節活動的過程中，發生次全脫位而造成關節軟骨的損傷或外側支持持韌帶疲乏而產生疼痛。
關於髕骨-股骨關節吻合度的問題，雖經許多學者的研究，但他們所用的方法不同，因此很難定出髕骨-股骨關節的正常排列標準。本研究綜合國外多位學者所採用的評估方法，針對本國年經，無症狀的年經人，做有系統的評估，試圖找出國人膝關節的正常排列架構，但髕骨-股骨關節的隱定性乃屬正常，則須更進一步的研究。
由本研究中，我們發現女性的膝關節排列比較趨向於隱定的狀態，因此我們呼籲女性同胞平時應多做強化股四頭肌中的股內側肌之肌力訓練，以增加肌肉對髕骨平衡的控制，以避免髕骨的次全脫位，預防前膝部疼痛症的發生。

並列摘要

Nontraumatic anterior knee pain is a problem disturbing patients and orthopaedic physician very much. After Laurin, Maerchant and Hughston’s studies, patellofemoral joint instability was recognized as the primary etiology of nontraumatic anterior knee pain. The patellofemoral joint stability may be influenced by many factors and the prime factor may be the bony architecture-the developmental structure of the joint. In order to find the normal knee architecture in our people, we randomly chose 200 asymptomatic young adults, 100 women and 100 men, to check their Q-angle, femorotibial angle, sulcus angle, congruence angle, patellofemoral angle, lateral pulling of patella and patellar height that concurrently affect the patellar stability.
In our study, Q-angle averaged 20±4 degrees in women and 13±3 degrees in men. The femortibial angle aver-aged 3±3 degrees both in women and men. The sulcus angle averaged 125±11degrees in women and 120±7 degrees in men. The congruence angle averaged -6±10 degrees in women and -12±8 degrees in men. The patellar height is 1.1±0.1, the same in women nand men. These data from our survey might suggest that wome have greater tendency toward patellofemoral joint malaignment. It conicdes with clinical observation that women have higher risk of anterior knee pain syndrome.

並列關鍵字

Patellofemoral joint ； Q-angle ； Femorotibial angle ； Sulcus angle ； Congruence angle ； Patellofemoral angle ； Lateral pulling