A Study Of The Correlation Between The Adaptation Abnormality Of Patellofemoral Joint Under MRI And Its Cartilage Injury

BackgroundInjury of patellofemoral arthrodial cartilage is a common disease in present articular surgery, and it is also hard to cure. The study shows that adaptable abnormality of the patellofemoral joint, which is caused by various factors, consequentially leads to stress distribution change of patellofemoral joint, and sequentially leads to the injury of patellofemoral arhthrodial cartilage. In present clinical treatments, there are many shortages of the main diagnostic methods of adaptable abnormality of patellofemoral joint (including the clinic stabilization examination, the imageologic examination, the arthroscopy, et al.). Therefore, an accurate, hurtless and effective method to evaluate the adaptable abnormality of patellofemoral joint is urgently needed and the correlation between the adaptable abnormality and cartilage injury should be established, which can provide a brief, accurate qualitative and quantitative index for the effective prevention and treatment of Injury of patellofemoral arthrodial cartilage. MRI examination, which is the most effective instrument to explore the correlation between the adaptable abnormality and cartilage injury, has its characteristics as follows:①It can provide a clear image of the structure and pathologic changes of patellofemoral joint and its surrounding tissues without injury②It can observe the adaptable abnormality of patellofemoral joint in polyangle and multilayer ways and accurately scale the cartilage injury.③Compared to X ray and CT, it can find out the pathologic changes such as bone edema under the cartilage, sclerosis and microfracture in an early stage. Therefore, MRI is regarded to be the best examination in the correlation between the adaptable abnormality of patellofemoral joint and cartilage injury,ObjectiveAiming to the early diagnosis of patellofemoral arthrosis, there is no research on the correlation between the adaptable abnormality of patellofemoral joint and cartilage injury to investigate an accurate and hurtles treatment to the adaptable abnormality of patellofemoral joint. Compared to the retrospective clinical case control study of the adaptable abnormality of patellofemoral joint cases., Our research, which is based on the study of the differences between the MRI measure value and anatomic measure value of patellofemoral joint, investigates the correlation between the index of the adaptable abnormality of the patellofemoral joint and the injury of the patellofemoral arthrodial cartilage with MRI, and provides brief, accurate and hurtless diagnostic methods and qualitative and quantitative index for the prevention and treatment of injury of patellofemral arthrodial cartilage.MethodsWe measure the anatomic body and the image of the regular sequence MRI examination of the patellofemoral adaptation's common parameters for 6 adult ex vivo knee joint samples in order to determinant whether there is difference between the value of MRI examination and anatomic body; We use the most effective image technique—MRI examination and the retrospective case-control study to do the statistical analysis of 338 individuals'(349 knees)patellofemoral joint adaptation index and whether they have cartilage injury in order to determinant the correlation between the patellofemral joint adaptable abnormality and its cartilage injury.Results: In the measure of the anatomic body and the image of the regular sequence MRI examination of the patellofemoral adaptation's common parameters of knee joint samples, there is statistical significance between them on the values of portrait diameter of femoral medial condyle, thickness of patella and thickness of medial collateral ligament(P<0.001-0.005);Other indexes (including width of patella, length of patella, length of patellar tendon, thickness of patellar tendon, transverse diameter of medial condyle, portrait diameter of lateral condyle, transverse diameter of intercondyloid fossa, portrait diameter of intercondyloid fossa, width of patellar medial surface, width of patellar lateral surface and the thickness of lateral collateral ligament)have no statistical significance between two measures. In the statistical analysis of the measures of patellofemoral joint adaptation index and whether they have the cartilage injury, the main measured indexes are patellofemoral adaptable angle, thickness of patella and width of patellofemoral joint's lateral gap(compare with normal control, P <0.001-0.005).ConclusionThe MRI measure value of adult ex vivo knees joint samples'patellofemoral joint adaptation indexes can veritably reflect the values of anatomic body. The width of patellofemoral joint's lateral gap, the ratio between width and thickness of patella (width/thickness) and the patellofemoral adaptable angle can be the objective indexes of early MRI diagnosis, and also can be the objective index of the selection the treatment time and the evaluation of treatment effect for patellofemoral arthrodial cartilage injury.