Prakash Jatin, Seon Jong-Keun, Woo Seong-Hwan, Jin Cheng, Song Eun-Kyoo
Department of Orthopedic Surgery, Lady Hardinge Medical College University of Delhi, New Delhi, India.
Department of Orthopaedic Surgery, Chonnam National University Bitgoeul Hospital, Gwangju, Korea.
Knee Surg Relat Res. 2016 Dec 1;28(4):302-311. doi: 10.5792/ksrr.16.010.
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.
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.
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.
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.
髌股关节不稳定是青少年和青年成人前膝痛的常见原因。大多数用于诊断髌股关节不稳定的正常和病理值基于西方文献。我们进行这项影像学研究,以确定韩国人群中不同髌股参数的正常值,并评估其在诊断中的效用。
我们回顾性分析了髌骨脱位组和对照组的旋转位计算机断层扫描(CT)图像。比较了两组之间的滑车、髌骨、旋转位及滑车-髌骨对线参数。绘制了显著参数的受试者工作特征曲线,并计算了截断值的敏感性和特异性。
髌骨脱位组有48例患者,对照组有87例患者。对照组和髌骨脱位组的平均沟角分别为132.5°和143.3°,滑车深度分别为6.04mm和3.6mm,平分偏移分别为56.4%和99.9%,髌骨外侧倾斜分别为9.8°和19.2°,髌骨小面不对称分别为63.5%和45.16%,胫骨结节-滑车沟(TT-TG)距离分别为10.91mm和27.16mm。
滑车深度、平分偏移、髌骨倾斜和TT-TG距离是导致髌骨不稳定的显著参数。旋转位CT可被视为评估所有这些参数的良好诊断工具,有助于识别导致髌股关节不稳定的解剖变异,从而有助于制定最有效的治疗方案。