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Patellar Tilt and Patellar Tendon-Trochlear Groove Angle Present the Optimum Magnetic Resonance Imaging Diagnostic Reliability for Patients With Patellar Instability.
- Source :
-
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2023 Nov; Vol. 39 (11), pp. 2339-2351. Date of Electronic Publication: 2023 Apr 26. - Publication Year :
- 2023
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Abstract
- Purpose: To describe, in controls and in a population with patellar instability, magnetic resonance imaging values of measurements representing major associated factors for patellar instability (patellar height, trochlear dysplasia, and extensor mechanism alignment), as well as their cutoff values.<br />Methods: In total, 323 knee magnetic resonance imaging scans, 142 with patellar instability and 181 controls without patellofemoral complaints (anterior cruciate, medial collateral ligament, meniscus ruptures or normal) were evaluated. Means, normality values in the control population, ideal cutoff values through receiver operating characteristic curves analysis, and interobserver reliability (intraclass correlation coefficient) were described for a series of measurements.<br />Results: All measurements were statistically different in control and instability patients, except for the patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance. The interobserver intraclass correlation coefficient was good or excellent (above 0.75) only for the patellotrochlear index, patellar tendon-trochlear groove (PTTG) angle, and patellar tilt. The optimal cutoff value for each measurement was: PTTG angle ≥25.3 <superscript>o</superscript> with sensitivity (S) of 70% and specificity (E) of 89%, patellar tilt ≥16 <superscript>o</superscript> (S: 69% and E: 84%), trochlear sulcus angle ≥153 <superscript>o</superscript> (S: 75% and E: 76%), Carrillon ≤12.8 <superscript>o</superscript> (S: 62% and E: 87%), PTTG distance ≥11mm (S: 71% and E: 78%), Caton-Deschamps index ≥1.23 (S: 72% and E: 76%) and trochlear bump ≥3.95 mm (S: 76% and E: 65%).<br />Conclusions: Caton-Deschamps index (≥1.23), trochlear sulcus angle (≥153 <superscript>o</superscript> ), ventral prominence of the trochlea (≥3.95 mm), PTTG distance (≥11 mm), PTTG angle (≥25.3 <superscript>o</superscript> ), Carrillon angle (≤12.8 <superscript>o</superscript> ), and patellar tilt (≥16 <superscript>o</superscript> ) presented better diagnostic performance for patellar instability. Patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance were not related to patellar instability. The interobserver reliability of the factors related to patellar instability was excellent only for the PTTG angle and lateral patellar tilt.<br />Level of Evidence: Level III, retrospective case-control study.<br /> (Copyright © 2023 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Retrospective Studies
Case-Control Studies
Reproducibility of Results
Magnetic Resonance Imaging
Tibia diagnostic imaging
Tibia pathology
Patellar Ligament diagnostic imaging
Joint Instability diagnostic imaging
Joint Instability pathology
Patellofemoral Joint diagnostic imaging
Patellofemoral Joint pathology
Patellar Dislocation diagnostic imaging
Patellar Dislocation pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1526-3231
- Volume :
- 39
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
- Publication Type :
- Academic Journal
- Accession number :
- 37116551
- Full Text :
- https://doi.org/10.1016/j.arthro.2023.04.005