青少年滑车与股骨远端骨骺的性别特异性发育：一项3D形状建模研究
简介
261例8–22岁非发育不良膝关节MRI的深度学习3D建模显示，13–19岁两性股骨远端骺板均向近端迁移、滑车加深，外侧深度大于内侧；16岁后男性尺寸标准化的外侧滑车深度显著大于女性。该性别与年龄差异可为骨骼未成熟患者滑车成形术的时机与方案提供解剖参考，但横断面设计限制临床干预推断。
英文摘要
BACKGROUND: Trochlear dysplasia is a primary risk factor for patellar instability and is associated with high recurrence rates, early arthritis, and poor return-to-sport outcomes. Surgical correction with trochleoplasty can improve tracking but carries risks in skeletally immature patients, including physeal damage and growth disturbance. PURPOSE: To inform safer surgical decision-making and refine current treatment strategies with a clearer understanding of how the trochlea and physis develop during adolescence is needed. STUDY DESIGN: Cross-sectional study; Level of evidence 3. METHODS: The authors retrospectively analyzed 261 nondysplastic knee magnetic resonance images from individuals aged 8 to 22 years. The authors trained a deep learning model to segment diaphyseal and epiphyseal femoral structures, and then constructed sex-specific statistical shape models of distal femoral shape and physis location. Regression analyses indicated a typical progression of femur shape with age. RESULTS: Between ages 13 and 19 years, both sexes demonstrated proximal migration of the physis and deepening of the trochlea, with greater lateral trochlear depth than medial trochlear depth. Across this age range, medial and lateral trochlear growth progressed at similar rates. After age 16, males demonstrated a significantly greater size-standardized lateral trochlear depth than females. CONCLUSION: These findings enhance understanding of sex-specific trochlear development and physeal positioning while demonstrating the utility of deep learning-based 3-dimensional modeling for characterizing knee growth.