改良单图像法手工测量髌骨不稳患者胫骨结节-股骨滑车沟间距的可行性分析

目的 探讨改良单图像法手工测量髌骨不稳患者胫骨结节-股骨滑车沟（tibial tuberosity-trochlear groove，TT-TG）间距的可行性。 方法 选取髌骨不稳患者30例。高年资手术医师A、B，使用改良单图像法手工测量髌骨不稳患者TT-TG间距，对比高资年影像学医师C，使用双图法测量髌骨不稳患者TT-TG间距。应用Cronbach′s alpha系数评价结果的可信度。应用组内相关系数（intraclass correlation coefficient，ICC）评价结果的可重复性。使用Bland-Altman分析图评价结果的一致性。 结果 高年资手术医师A、B使用改良单图像法手工测量髌骨不稳患者TT-TG间距分别和高年资影像学医师C使用双图法测量髌骨不稳患者TT-TG间距比较，Cronbach′s alpha系数分别为0.913和0.959，组内相关系数分别为0.913和0.958。Bland-Altman分析图显示，TT-TG间距差值（mm）的均值为-0.276（95%CI：-3.526~2.974）和0.143（95%CI：-3.110~3.397）。A、B医师之间使用改良单图像法手工测量髌骨不稳患者TT-TG间距比较，Cronbach′s alpha系数为0.891，组内相关系数为0.891。Bland-Altman分析图显示TT-TG间距差值（mm）的均值为-0.276（95%CI：-3.526~2.974）。 结论 改良单图像法手工测量髌骨不稳患者TT-TG间距操作简单，可以准确测量出髌骨不稳患者的TT-TG间距，该方法和双图法可以相互替换使用。

The feasibility analysis of the manual measurement of the tibial tuberosity-trochlear groove distance in the patient with patellar instability by modified single image method

Objective To discuss the feasibility of manual measurement of the tibial tuberosity-trochlear groove(TT-TG) distance in the patient with patellar instability by modified single image method. Methods Thirty cases patients with patellar instability were selected. Senior surgeons A and B measured the TT-TG distance of patients with patellar instability by modified single-image method and compared with senior radiologist C who measured the TT-TG distance of patients with patellar instability by double-image method.The Cronbach′s alpha coefficient was used to evaluate the reliability of the results.The intraclass correlation coefficient was used to evaluate the repeatability of the results.The Bland-Altman analysis diagram was used to evaluate the consistency of the results. Results Senior surgeons A and B who measured the TT-TG distance of patients with patellar instability by modified single-image method compared with senior radiologist C who measured the TT-TG distance of patients with patellar instability by double-image method: Cronbach′s alpha coefficients were 0.913 and 0.959, respectively.The intragroup correlation coefficients were 0.913 and 0.958, respectively. The Bland-Altman analysis diagrams showed that the mean of TT-TG distance D-value(mm) was -0.276(95% CI：-3.526-2.974) and 0.143 (95% CI：-3.110-3.397). Senior surgeons A and B used the modified method to measure TT-TG distance manually in patellar instability patients.The Cronbach′s alpha coefficient was 0.891. The intragroup correlation coefficient was 0.891. 〖JP2〗The Bland-Altman analysis showed that the mean of TT-TG distance difference(mm) was -0.276 (95% CI：〖JP〗-3.526-2.974). Conclusion The modified single image method is simple to measure TT-TG distance manually in patients with patellar instability. It can accurately measure TT-TG distance in patients with patellar instability. This method and double image method can be used interchangeably.