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膝骨关节炎病因 X线片及临床表现分析 |
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叶永平 蒋垚 曾炳芳
【摘要】 目的 探讨国人膝骨关节炎病因、临床表现和X线片的相关性，为临床诊治提供依据。方法 对骨科门诊膝骨关节炎患者进行病因、临床表现调查，摄单腿站立位膝关节正侧位、髌骨轴位片，分析X线征象并作骨关节炎分级、分型。结果 膝骨关节炎原发性占87%，继发性占13%。膝骨关节炎分型：初期型38%，髌股型28.5%，内侧-髌股型23.2%。随关节炎分类程度的加重，临床症状向严重发展（P<0.01）。胫股角越大，X线分级趋向病变加重(P<0.01)。结论 膝骨关节炎以原发性为主。国人膝骨关节炎除初期型外，以髌股型和内侧-髌股型多见。膝内外翻畸形是症状加重的主要诱因。
【关键词】膝关节；骨关节炎
【中图分类号】 R684.3 【文献标识码】 A
【文章编号】 1008-0287(2000)03-0169-05
Analysis of etiology, roentgenography and clinical manifestation of knee osteoarthritis
Ye Yongping, Jiang Yao, Zeng Bingfang
(Dept of Orthopaedics, Fuzhou General Hospital of Nanjing Military Command，Fuzhou,Fujian,350025)
【Abstract】 Objecive To explore the relationship between the etiology and radiological characteristics and clinical manifestations of osteoarthritis (OA)of the knee, providing basis for the treatment. Methods The etiology, clinical manifestations of outdoor patients with osteoarthritis of the knee were investigated, and standing anteroposterior, lateral and axial film of patellofemoral joint analyzed, OA grading, and classification was also evaulated. Results 87% cases were primary,and 13% secondary osteoarthritis. According to the classification of roentgenography,38% were preliminary type,28.5% patellofemoral type and 23.2% for the medio-patellofemoral type. Radiological classification was related with the clinical manifestations (P<0.01).If the varus and valgus deformity was severer, X-ray grading would become severer(P<0.01).Conclusion Primary osteoarthritis of the knee is more common than secondary type. Besides preliminary, patellofemoral and medio-patellofemoral type are common. Varus or valgus deformity of knee joint will increase the severity of clinical manifestation of OA of the knee.
【Key words】knee joint；osteoarthritis
膝骨关节炎是一种慢性进行性骨关节病，多见于中老年人，Kellgren经随机抽样的统计学分析结果表明，55～64岁的中老年人发病率高达40%。其致病因素多种多样，但造成的病损却有相似的生物学、形态学特征。疾病的整个过程不仅影响到关节软骨，还涉及整个关节，包括软骨下骨、韧带、关节囊、[1] [2] 下一页
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