Abstract

Purpose

This systematic review aimed to evaluate the variability of patellofemoral (PF) alignment and trochlear morphology in osteoarthritic knees.

Methods

PF alignment of the knee was defined by the following parameters: the sulcus angle (SA), femoral trochlear depth (FTD), patellar tilt angle (PTA), lateral patellofemoral angle (LPFA), lateral femoral trochlear inclination (LFTI) and tibial tubercle–trochlear groove distance (TT–TG). The electronic databases MEDLINE and EMBASE were searched from database inception to the search date (February 19, 2019) and were screened for relevant studies. The PRISMA guidelines were followed. Articles reporting PF alignment measurements of osteoarthritic knees in patients over 40 years old were included. Data were extracted and methodological quality was assessed using a 14-item checklist.

Results

A total of 8 studies met the inclusion criteria. The studies reported mean values ± SD between 120° and 141.1° ± 7.7 for the SA; 5.8 mm ± 1.4 for the FTD; between − 0.1° ± 3.3 and 10.3° ± 5.7 for the PTA; between 5.8° ± 5.4 and 17° for the LPFA; between 23.2° ± 5.0 and 27.1° ± 4.4 for the LFTI; and 5.8 mm ± 5.4 for the TT-TG.

Conclusion

PF alignment in the osteoarthritic knee is more variable than expected. This finding should encourage surgeons to consider the individual preoperative PF alignment more precisely with the aim of reducing anterior knee pain (AKP) after TKA. 3D-CT imaging might be of great value to analyse the PF alignment in an appropriate way.

Level of evidence

Level III.

中文翻译：

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骨关节炎膝盖的tell股对准高度可变：系统综述

摘要

目的

该系统评价旨在评估骨关节炎膝关节knee股（PF）排列和滑车形态的变异性。

方法

膝盖的PF对齐由以下参数定义：沟角（SA），股骨滑车深度（FTD），pa骨倾斜角（PTA），外侧pa股角（LPFA），外侧股骨滑车倾斜度（LFTI）和胫骨结节–滑车凹槽距离（TT–TG）。从数据库开始到搜索日期（2019年2月19日），搜索了MEDLINE和EMBASE电子数据库，并对相关研究进行了筛选。遵循PRISMA指南。包括报告40岁以上患者骨关节炎膝关节PF对准测量的文章。提取数据并使用14个项目的清单评估方法学质量。

结果

共有8项研究符合纳入标准。研究报告SA的平均值±SD在120°至141.1°±7.7之间；FTD为5.8毫米±1.4; 对于PTA，介于− 0.1°±3.3至10.3°±5.7之间；LPFA在5.8°±5.4和17°之间; LFTI在23.2°±5.0和27.1°±4.4之间; TT-TG为5.8 mm±5.4。

结论

骨关节炎膝盖的PF对齐比预期的要多。这一发现应鼓励外科医生更准确地考虑术前PF的个体对准，以减少TKA后的前膝痛（AKP）。3D-CT成像对于以适当方式分析PF对准可能具有重要价值。

证据水平

第三级。