Discrepancies of Patellofemoral Indices between Supine and Standing Merchant Views
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: This research was conducted to compare supine and standing Merchant views, to observe radiographic changes of the patellofemoral joint according to weight-bearing conditions, and to evaluate correlation factors affecting patellofemoral joint indices.Materials and Methods: Forty-four patients without skeletal problems were selected for this study. Patellar tilt angle, lateral patellofemoral angle, congruence angle, lateral subluxation distance and lateral patellar displacement were measured on each radiograph and evaluated for statistical significance. Possible correlation factors that can affect the radiographic discrepancy were analyzed using the univariate and multivariate regression analysis.Results: In the standing Merchant view, the patellar tilt angle, congruence angle and lateral patellar displacement were significantly decreased (p<0.001), whereas the lateral patellofemoral angle was significantly increased (p<0.001) compared to that in the supine Merchant view. Thigh width (p<0.001, r2=0.22) and radiographic Q-angle (p<0.001, r2=0.34) were found correlated with the radiographic discrepancy of congruence angle. Discrepancy of the lateral patella displacement increased as radiographic Q-angle increased (p=0.027, r2=0.112).Conclusions: Compared with the supine Merchant view, standing (weight-bearing) Merchant view showed decreased patella tilt angle, congruence angle, and lateral patella displacement. The results indicate that both supine and standing Merchant views should be considered in the radiographic evaluation of the patellofemoral joint.
Abstract
Purpose: This research was conducted to compare supine and standing Merchant views, to observe radiographic changes of the patellofemoral joint according to weight-bearing conditions, and to evaluate correlation factors affecting patellofemoral joint indices.Materials and Methods: Forty-four patients without skeletal problems were selected for this study. Patellar tilt angle, lateral patellofemoral angle, congruence angle, lateral subluxation distance and lateral patellar displacement were measured on each radiograph and evaluated for statistical significance. Possible correlation factors that can affect the radiographic discrepancy were analyzed using the univariate and multivariate regression analysis.Results: In the standing Merchant view, the patellar tilt angle, congruence angle and lateral patellar displacement were significantly decreased (p<0.001), whereas the lateral patellofemoral angle was significantly increased (p<0.001) compared to that in the supine Merchant view. Thigh width (p<0.001, r2=0.22) and radiographic Q-angle (p<0.001, r2=0.34) were found correlated with the radiographic discrepancy of congruence angle. Discrepancy of the lateral patella displacement increased as radiographic Q-angle increased (p=0.027, r2=0.112).Conclusions: Compared with the supine Merchant view, standing (weight-bearing) Merchant view showed decreased patella tilt angle, congruence angle, and lateral patella displacement. The results indicate that both supine and standing Merchant views should be considered in the radiographic evaluation of the patellofemoral joint.
참고문헌 (25)
- Fulkerson JP, "Diagnosis and treatment of patients with patellofemoral pain", Am J Sports Med, 30, pp.447~456 (2002)
- DeHaven KE, "Athletic injuries : comparison by age, sport, and gender", Am J Sports Med, 14, pp.218~224 (1986)
- Fredericson M, "Physical examination and patellofemoral pain syndrome", Am J Phys Med Rehabil, 85, pp.234~243 (2006)
- Draper CE, "Differences in patellofemoral kinematics between weight-bearing and non-weight-bearing conditions in patients with patellofemoral pain", J Orthop Res, 29, pp.312~317 (2011)
- Baldini A, "Validation of a new weight-bearing axial radiographic view", J Bone Joint Surg Am, 89, pp.1810~1817 (2007)
- Nha KW, "In vivo patellar tracking : clinical motions and patellofemoral indices", J Orthop Res, 26, pp.1067~1074 (2008)
- Noehren B, "A comparison of tibiofemoral and patellofemoral alignment during a neutral and valgus single leg squat : an MRI study", Knee, 19, pp.380~386 (2012)
- Draper CE, "Using real-time MRI to quantify altered joint kinematics in subjects with patellofemoral pain and to evaluate the effects of a patellar brace or sleeve on joint motion", J Orthop Res, 27, pp.571~577 (2009)
- Wilson NA, "In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain", J Bone Joint Surg Am, 91, pp.558~566 (2009)
- Brossmann J, "Patellar tracking patterns during active and passive knee extension : evaluation with motion-triggered cine MR imaging", Radiology, 187, pp.205~212 (1993)
- Powers CM, "Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella : a preliminary study", J Orthop Sports Phys Ther, 33, pp.677~685 (2003)
- McWalter EJ, "The effect of load magnitude on three-dimensional patellar kinematics in vivo", J Biomech, 43, pp.1890~1897 (2010)
- Fukui N, "A modified system of stress radiography for patellofemoral instability", J Bone Joint Surg Br, 85, pp.1128~1133 (2003)
- Grelsamer RP, "Patellar tilt : the physical examination correlates with MR imaging", Knee, 15, pp.3~8 (2008)
- Stensdotter AK, "Quadriceps activation in closed and in open kinetic chain exercise", Med Sci Sports Exerc, 35, pp.2043~2047 (2003)
- Shellock FG, "Patellofemoral joint : identification of abnormalities with active-movement, "unloaded"versus"loaded"kinematic MR imaging techniques", Radiology, 188, pp.575~578 (1993)
- Post WR, "Patellofemoral malalignment : looking beyond the viewbox", Clin Sports Med, 21, pp.521~546 (2002)
- Lee TQ, "The influence of tibial and femoral rotation on patellofemoral contact area and pressure", J Orthop Sports Phys Ther, 33, pp.686~693 (2003)
- Koo S, "The knee joint center of rotation is predominantly on the lateral side during normal walking", J Biomech, 41, pp.1269~1273 (2008)
- Blaha JD, "Kinematics of the human knee using an open chain cadaver model", Clin Orthop Relat Res, 410, pp.25~34 (2003)
- Dennis DA, "In vivo determination of normal and anterior cruciate ligament-deficient knee kinematics", J Biomech, 38, pp.241~253 (2005)
- Freeman MA, "The movement of the normal tibio-femoral joint", J Biomech, 38, pp.197~208 (2005)
- Iwaki H, "Tibiofemoral movement 1 : the shapes and relative movements of the femur and tibia in the unloaded cadaver knee", J Bone Joint Surg Br, 82, pp.1189~1195 (2000)
- Dyrby CO, "Secondary motions of the knee during weight bearing and non-weight bearing activities", J Orthop Res, 22, pp.794~800 (2004)
- Hoshino Y, "Internal tibial rotation during in vivo, dynamic activity induces greater sliding of tibio-femoral joint contact on the medial compartment", Knee Surg Sports Traumatol Arthrosc, 20, pp.1268~1275 (2012)