目的 :观察成年人高位髌骨患者的X线改变 ,并根据X线改变进行临床分级 ,以估计预后和指导临床治疗。方法 :对临床诊断为高位髌骨的 18例成年患者 ,共计 34侧膝关节 ,进行屈膝 30°侧位片和髌骨轴位片的拍摄 ,然后在X片上测定Blumensaat距离、髌骨高度、股骨滑车沟角、髌股协调角、外侧髌股角、髌股指数、髌骨外移度七项参数 ,并与对照组进行比较。选用Blumensaat距离 ,髌骨高度及髌股协调角作为临床分级的参数指标。结果 :病例组与对照组比较 :Blumen saat距离 ,髌骨高度的差异有非常显著性意义 (P <0 .0 1) ;髌股协调角、外侧髌股角、髌股指数、髌骨外移度的差异有显著性意义 (P <0 .0 5 ) ;股骨滑车沟角的差异无显著性意义 (P >0 .0 5 )。临床分级 :10侧膝关节属轻度 ,表现为髌骨软骨软化症 ,药物疗效好 ;2 1侧属重度 ,表现为髌股关节骨关节炎 ,药物疗效差。结论 :成年人高位髌骨的X线改变以髌骨的异常高位为主 ,伴有一定程度的髌骨外移和向外侧倾斜 ,临床分级在定性诊断的基础上 ,融入了定量诊断 ,有进一步研究的必要性 OBJECTIVE: To observe the X-ray changes of adult patients with high patella, and to evaluate the prognosis and guide the clinical treatment according to the X-ray changes. Methods: Twenty-eight adult patients with clinically diagnosed high patella were enrolled in this study. A total of 34 knees were examined with 30 ° flexion lateral and patellar axial radiographs. The Blumensaat distance, patella height, , Patellofemoral coordination angle, lateral patellofemoral angle, patellofemoral index, patellar shift seven parameters, and compared with the control group. Blumensaat distance, patellar height and patellofemoral angle were chosen as the parameters of clinical grade. Results: Compared with the control group, the difference of Blumen saat distance and height of patella had significant difference (P <0.01); the angle of patellofemoral joint, lateral patellofemoral angle, patellofemoral index and patellar shift The difference was significant (P <0.05). There was no significant difference in the groove angle of the femur (P> 0.05). Clinical grade: 10 side of the knee is mild, showing chondromalacia patellae, drug efficacy is good; 21 side of severe, manifested as patellofemoral joint osteoarthritis, poor efficacy of the drug. CONCLUSION: X-ray changes of high patella are mainly abnormally high in the patella with a certain degree of patellar shift and tilt to the outside. Based on the qualitative diagnosis, the clinical grade is integrated into the quantitative diagnosis, which is necessary for further study Sex