霍法脂肪垫综合征的诱发因素:系统综述。

IF 4.1 Q1 ORTHOPEDICS Knee Surgery & Related Research Pub Date : 2023-06-09 DOI:10.1186/s43019-023-00192-4
Diego Agustín Abelleyra Lastoria, Clerin Kulangara Benny, Caroline Blanca Hing
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引用次数: 0

摘要

背景:霍法脂肪垫综合征被定义为霍法脂肪垫撞击导致水肿和纤维化。本系统综述的主要目的是确定霍法脂肪垫综合征患者与非霍法脂肪垫综合征患者之间的形态学差异,并将其作为导致霍法脂肪垫综合征的风险因素进行评估。其次是总结和评估与霍法脂肪垫综合征治疗相关的现有证据:本综述的方案已进行前瞻性注册(PROSPERO 注册:CRD42022357036)。检索了电子数据库、当前注册的研究、会议论文集以及纳入研究的参考文献列表。纳入了所有评估霍法脂肪垫综合征患者和非霍法脂肪垫综合征患者在影像学下的霍法脂肪垫解剖学差异的研究,以及探讨易导致霍法脂肪垫综合征的流行病学因素(种族、就业状况、性别、年龄和体重指数)的研究,以及报告治疗对霍法脂肪垫形态学影响的研究:结果:共筛选出 3871 条记录。结果:共筛选出 3871 条记录,其中 21 篇符合纳入标准,对 3518 名患者的 3603 个膝关节进行了评估。研究发现,髌骨突出、胫骨结节-胫骨沟距离增大和蹄骨角增大易导致霍法脂肪垫综合征的发生。而趾骨倾角、胫沟角、患者年龄和体重指数与此病无关。由于缺乏证据,因此无法确定霍法脂肪垫综合征与种族、就业、髌骨排列、霍法脂肪垫组成、体育锻炼和其他病理过程之间的联系。没有发现有关霍法脂肪垫综合征治疗方法的研究报告。虽然减肥和基因治疗可能会缓解症状,但还需要进一步的研究来证实这些说法:目前的证据表明,髌骨高度、TT-TG 距离和套管角度过高容易导致霍法脂肪垫综合征的发生。此外,跗关节倾角、跗关节沟角度、患者年龄和体重指数似乎与此病无关。进一步的研究应探讨霍法脂肪垫综合征与运动以及与膝关节有关的其他疾病之间的联系。此外,还需要进一步研究评估霍法脂肪垫综合征的治疗方法。
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Predisposing factors for Hoffa's fat pad syndrome: a systematic review.

Background: Hoffa's fat pad syndrome has been defined as impingement of Hoffa's fat pad, leading to oedema and fibrosis. The primary aim of this systematic review was to identify morphological differences in Hoffa's fat pad between patients with and without Hoffa's fat pad syndrome, evaluating them as risk factors predisposing to its development. The secondary aim was to summarize and evaluate current evidence pertaining to the management of Hoffa's fat pad syndrome.

Materials and methods: The protocol for this review was prospectively registered (PROSPERO registration: CRD42022357036). Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. All studies evaluating differences in Hoffa's fat pad anatomy under imaging between patients with and without Hoffa's fat pad syndrome were included, as well as those exploring epidemiological factors predisposing to its development (ethnicity, employment status, sex, age and BMI), and studies reporting on the effect of treatment on Hoffa's fat pad morphology.

Results: A total of 3871 records were screened. Twenty one articles satisfied the inclusion criteria, evaluating 3603 knees of 3518 patients. Patella alta, increased tibial tubercle-tibial groove distance, and increased trochlear angle were found to predispose the development of Hoffa's fat pad syndrome. Trochlear inclination, sulcus angle, patient age and BMI were not associated with this condition. The link between Hoffa's fat pad syndrome and ethnicity, employment, patellar alignment, Hoffa's fat pad composition, physical activity and other pathological processes cannot be established due to lack of evidence. No studies reporting on treatment for Hoffa's fat pad syndrome were identified. Though weight loss and gene therapy may provide symptomatic relief, further research is required to corroborate these claims.

Conclusion: Current evidence suggests that high patellar height, TT-TG distance, and trochlear angle predispose the development of Hoffa's fat pad syndrome. In addition, trochlear inclination, sulcus angle, patient age and BMI do not seem to be associated with this condition. Further research should explore the link between Hoffa's fat pad syndrome and sport as well as other conditions pertaining to the knee. In addition, further study evaluating treatment approaches for Hoffa's fat pad syndrome is required.

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