Comparison of Radiological Parameters between Normal and Patellar Dislocation Groups in Korean Population: A Rotational Profile CT-Based Study
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purpose: Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adults. Most normal and pathological values for diagnosing patellofemoral instability are based on Western literature. We conducted this radiological study to determine normal values for different patellofemoral parameters in a Korean population and to evaluate their usefulness in diagnosis.Materials and Methods: We retrospectively reviewed the rotational profile computerized tomography (CT) scans of the patellar dislocation and control groups. Trochlear, patellar, rotational profile, and trochleo-patellar alignment parameters were compared between the groups. Receiver operating characteristic curves were drawn for significant parameters, and sensitivity and specificity were calculated for the cut-off values.results: There were 48 patients in the patellar dislocation group and 87 patients in the control group. In the control group and patellar dislocation group, the mean sulcus angle was 132.5° and 143.3°, respectively, trochlear depth was 6.04 mm and 3.6 mm, bisect offset was 56.4% and 99.9%, lateral patellar tilting was 9.8° and 19.2°, patellar facet asymmetry was 63.5% and 45.16%, and the tibial tuberosity-trochlear groove (TT-TG) distance was 10.91 mm and 27.16 mm, respectively.conclusions: The trochlear depth, bisect offset, patella tilting, and TT-TG distance were parameters that significantly contributed to patellar instability. Rotational profile CT can be considered a good diagnostic tool to assess all these parameters that help to identify anatomical aberration resulting in patellofemoral instability, thereby helping in formulating the most effective treatment plan.
Abstract
purpose: Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adults. Most normal and pathological values for diagnosing patellofemoral instability are based on Western literature. We conducted this radiological study to determine normal values for different patellofemoral parameters in a Korean population and to evaluate their usefulness in diagnosis.Materials and Methods: We retrospectively reviewed the rotational profile computerized tomography (CT) scans of the patellar dislocation and control groups. Trochlear, patellar, rotational profile, and trochleo-patellar alignment parameters were compared between the groups. Receiver operating characteristic curves were drawn for significant parameters, and sensitivity and specificity were calculated for the cut-off values.results: There were 48 patients in the patellar dislocation group and 87 patients in the control group. In the control group and patellar dislocation group, the mean sulcus angle was 132.5° and 143.3°, respectively, trochlear depth was 6.04 mm and 3.6 mm, bisect offset was 56.4% and 99.9%, lateral patellar tilting was 9.8° and 19.2°, patellar facet asymmetry was 63.5% and 45.16%, and the tibial tuberosity-trochlear groove (TT-TG) distance was 10.91 mm and 27.16 mm, respectively.conclusions: The trochlear depth, bisect offset, patella tilting, and TT-TG distance were parameters that significantly contributed to patellar instability. Rotational profile CT can be considered a good diagnostic tool to assess all these parameters that help to identify anatomical aberration resulting in patellofemoral instability, thereby helping in formulating the most effective treatment plan.
참고문헌 (30)
- Galland O, "An anatomical and radiological study of the femoropatellar articulation", Surg Radiol Anat, 12, pp.119~125 (1990)
- Aglietti P, "Surgery of the Knee", pp.246~251 (2001), Churchill Livingstone
- Aulisa AG, "Galeazzi’s modified technique for recurrent patella dislocation in skeletally immature patients", J Orthop Sci, 17, pp.148~155 (2012)
- Biedert RM, "Anterior-posterior trochlear measurements of normal and dysplastic trochlea by axial magnetic resonance imaging", Knee Surg Sports Traumatol Arthrosc, 17, pp.1225~1230 (2009)
- Blumensaat C, "Patellofemoral disorders : physical and radiographic evaluation", Chir U Orthop, 31, pp.149~223 (1938)
- Colvin AC, "Patellar instability", J Bone Joint Surg Am, 90, pp.2751~2762 (2008)
- Conlan T, "Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee", J Bone Joint Surg Am, 75, pp.682~693 (1993)
- Dejour H, "Factors of patellar instability : an anatomic radiographic study", Knee Surg Sports Traumatol Arthrosc, 2, pp.19~26 (1994)
- Inoue M, "Computed tomography analysis of patellofemoral congruence", J Bone Joint Surg Am, 70, pp.1331~1337 (1988)
- Insall J, "Patella position in the normal knee joint", Radiology, 101, pp.101~104 (1971)
- Martinez S, "Diagnosis of patellofemoral malalignment by computed tomography", J Comput Assist Tomogr, 7, pp.1050~1053 (1983)
- Alemparte J, "Patellofemoral evaluation with radiographs and computed tomography scans in 60 knees of asymptomatic subjects", Arthroscopy, 23, pp.170~177 (2007)
- Laurin CA, "The tangential x-ray investigation of the patellofemoral joint: x-ray technique, diagnostic criteria and their interpretation", Clin Orthop Relat Res, (144), pp.16~26 (1979)
- Harbaugh CM, "Correlating femoral shape with patellar kinematics in patients with patellofemoral pain", J Orthop Res, 28, pp.865~872 (2010)
- Stefanik JJ, "Association between measures of patella height, morphologic features of the trochlea, and patellofemoral joint alignment : the MOST study", Clin Orthop Relat Res, 471, pp.2641~2648 (2013)
- Haim A, "Patellofemoral pain syndrome : validity of clinical and radiological features", Clin Orthop Relat Res, 451, pp.223~228 (2006)
- Wiberg G, "Roentgenographs and anatomic studies on the femoropatellar joint : with special reference to chondromalacia patellae", Acta Orthop Scand, 12, pp.319~410 (1941)
- Grelsamer RP, "The biomechanics of the patellofemoral joint", J Orthop Sports Phys Ther, 28, pp.286~298 (1998)
- Guzzanti V, "Patellofemoral malalignment in adolescents : computerized tomographic assessment with or without quadriceps contraction", Am J Sports Med, 22, pp.55~60 (1994)
- Martinez S, "Diagnosis of patellofemoral malalignment by computed tomography", J Comput Assist Tomogr, 7, pp.1050~1053 (1983)
- Schueda MA, "Use of computed tomography to determine the risk of patellar dislocation in 921 patients with patellar instability", Open Access J Sports Med, 6, pp.55~62 (2015)
- Maas A, "Differences in anatomy and kinematics in Asian and Caucasian TKA patients : influence on implant positioning and subsequent loading conditions in mobile bearing knees", Biomed Res Int, 2014, pp.612838~ (2014)
- Yue B, "Differences of knee anthropometry between Chinese and white men and women", J Arthroplasty, 26, pp.124~130 (2011)
- Kim TK, "Special considerations for TKA in Asian patients : editorial comment", Clin Orthop Relat Res, 471, pp.1439~1440 (2013)
- Diederichs G, "MR imaging of patellar instability : injury patterns and assessment of risk factors", Radiographics, 30, pp.961~981 (2010)
- Laurin CA, "The abnormal lateral patellofemoral angle : a diagnostic roentgenographic sign of recurrent patellar subluxation", J Bone Joint Surg Am, 60, pp.55~60 (1978)
- Merchant AC, "Roentgenographic analysis of patellofemoral congruence", J Bone Joint Surg Am, 56, pp.1391~1396 (1974)
- Fulkerson JP, "Disorders of the patellofemoral joint", pp.211~239 (2004), Lippincott Williams &Wilkins
- Endo Y, "Radiologic assessment of patellofemoral pain in the athlete", Sports Health, 3, pp.195~210 (2011)
- Tensho K, "What components comprise the measurement of the tibial tuberosity-trochlear groove distance in a patellar dislocation population?", J Bone Joint Surg Am, 97, pp.1441~1448 (2015)