Back to Search
Start Over
Lateralization of the Tibial Tubercle in Recurrent Patellar Dislocation: Verification Using Multiple Methods to Evaluate the Tibial Tubercle
- Source :
- The Journal of bone and joint surgery. American volume. 100(9)
- Publication Year :
- 2018
-
Abstract
- Background The tibial tubercle deviation associated with recurrent patellar dislocation (RPD) has not been studied sufficiently. New methods of evaluation were used to verify the extent of tubercle deviation in a group with patellar dislocation compared with that in a control group, the frequency of patients who demonstrated a cutoff value indicating that tubercle transfer was warranted on the basis of the control group distribution, and the validity of these methods of evaluation for diagnosing RPD. Methods Sixty-six patients with a history of patellar dislocation (single in 19 [SPD group] and recurrent in 47 [RPD group]) and 66 age and sex-matched controls were analyzed with the use of computed tomography (CT). The tibial tubercle-posterior cruciate ligament (TT-PCL) distance, TT-PCL ratio, and tibial tubercle lateralization (TTL) in the SPD and RPD groups were compared with those in the control group. Cutoff values to warrant 10 mm of transfer were based on either the minimum or -2SD (2 standard deviations below the mean) value in the control group, and the prevalences of patients in the RPD group with measurements above these cutoff values were calculated. The area under the curve (AUC) in receiver operating characteristic (ROC) curve analysis was used to assess the effectiveness of the measurements as predictors of RPD. Results The mean TT-PCL distance, TT-PCL ratio, and TTL were all significantly greater in the RPD group than in the control group. The numbers of patients in the RPD group who satisfied the cutoff criteria when they were based on the minimum TT-PCL distance, TT-PCL ratio, and TTL in the control group were 11 (23%), 7 (15%), and 6 (13%), respectively. When the cutoff values were based on the -2SD values in the control group, the numbers of patients were 8 (17%), 6 (13%), and 0, respectively. The AUC of the ROC curve for TT-PCL distance, TT-PCL ratio, and TTL was 0.66, 0.72, and 0.72, respectively. Conclusions The extent of TTL in the RPD group was not substantial, and the percentages of patients for whom 10 mm of medial transfer was indicated were small. Level of evidence Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- Male
Torsion Abnormality
Tubercle
Recurrent patellar dislocation
Patellar Dislocation
Multiple methods
Lateralization of brain function
Cruciate ligament
03 medical and health sciences
Young Adult
0302 clinical medicine
Recurrence
medicine
Cutoff
Humans
Orthopedics and Sports Medicine
Retrospective Studies
030222 orthopedics
Receiver operating characteristic
Tibia
business.industry
Area under the curve
030229 sport sciences
General Medicine
musculoskeletal system
medicine.anatomical_structure
Case-Control Studies
Surgery
Female
Nuclear medicine
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 15351386
- Volume :
- 100
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- The Journal of bone and joint surgery. American volume
- Accession number :
- edsair.doi.dedup.....afcfe2ba5c025bb652a99a8dbbd720a3