Arslan Fatma Zeynep, Oğuzdoğan Gülşen Yücel
Department of Radiology, Basaksehir Cam and Sakura City Hospital, İstanbul, Turkey.
Quant Imaging Med Surg. 2024 Dec 5;14(12):9497-9505. doi: 10.21037/qims-23-1722. Epub 2024 Aug 8.
Insall-Salvati index (ISI) is widely used to evaluate patella position, the specific relationship between quadriceps patellar tendon angle (QPA) and patellofemoral measurements remains unclear. Understanding this relationship could provide valuable insights into diagnosing and treating knee pain, instability, and patellofemoral pathologies more effectively. In this study, we aimed to assess whether there was a significant difference between the patients with patella alta and baja in terms of many patellofemoral measurements and pathologies. Furthermore, we evaluated a newly described QPA.
A retrospective cross-sectional study including 446 patients who underwent knee magnetic resonance imaging (MRI) between 2019 and 2021 in Basaksehir City Hospital was conducted. Two hundred and five patients were divided into two groups according to their ISI (ISI >1.3 and ISI <0.8). The patellar tendon length, patellar height, patella angle, lateral patellar tilt angle (LPTA), patella-patellar tendon angle (PPTA), QPA, medial and lateral trochlear inclination, patella angle, trochlear sulcus angle (TSA), trochlear groove depth (TGD), medial and lateral trochlea length (LT), medial trochlea length (MT) and LT ratio and tibial tubercle-trochlear groove distance, fat-pad edema, chondromalacia and effusion were evaluated. Whether the measurement or presence of pathology differed significantly according to ISI were investigated. The difference between two arithmetic means were analyzed with -test. The Mann-Whitney U test were used for assessing the difference between two independent groups and to determine difference or equality between groups.
When the groups with ISI >1.3 and <0.8 were compared with each other in terms of measurements, patellar tendon length, tibial tubercle-trochlear groove distance, LPTA, PPTA, QPA were found to be significantly higher in the group with ISI >1.3 (P<0.05). Patellar height and TGD were significantly greater in the group with ISI <0.8 (P<0.001, P=0.007). Patellar tendon length, patellar tendon height, tibial tubercle-trochlear groove distance, patella angle, TGD, MT and LT, PPTA, QPA, medial trochlear inclination values and frequency of fat-pad edema were significantly higher in men (P<0.001). The ISI, TSA and frequency of chondromalacia was found to be significantly higher in women (P<0.001).
Major angles such as LPTA, PPTA, patellar tendon length, tibial tubercle-trochlear groove distance and QPA were increased in the group with patella alta. The patients with patella baja have higher patellar height and TGD.
Insall-Salvati指数（ISI）被广泛用于评估髌骨位置，股四头肌髌腱角（QPA）与髌股测量值之间的具体关系仍不清楚。了解这种关系可为更有效地诊断和治疗膝关节疼痛、不稳定及髌股关节病变提供有价值的见解。在本研究中，我们旨在评估高位髌骨和低位髌骨患者在多种髌股测量值和病变方面是否存在显著差异。此外，我们评估了一种新描述的QPA。
进行了一项回顾性横断面研究，纳入了2019年至2021年在巴塞克谢希尔市医院接受膝关节磁共振成像（MRI）检查的446例患者。根据ISI（ISI>1.3和ISI<0.8）将205例患者分为两组。评估了髌腱长度、髌骨高度、髌骨角、髌骨外侧倾斜角（LPTA）、髌骨-髌腱角（PPTA）、QPA、内外侧滑车倾斜度、髌骨角、滑车沟角（TSA）、滑车沟深度（TGD）、内外侧滑车长度（LT）、内侧滑车长度（MT）及LT比值以及胫骨结节-滑车沟距离、脂肪垫水肿、软骨软化和积液情况。研究测量值或病变的存在是否根据ISI有显著差异。两组算术平均值的差异采用t检验分析。采用曼-惠特尼U检验评估两个独立组之间的差异，并确定组间差异或相等情况。
当比较ISI>1.3和<0.8的两组测量值时，发现ISI>1.3组的髌腱长度、胫骨结节-滑车沟距离、LPTA、PPTA、QPA显著更高（P<0.05）。ISI<0.8组的髌骨高度和TGD显著更大（P<0.001，P=0.007）。男性的髌腱长度、髌腱高度、胫骨结节-滑车沟距离、髌骨角、TGD、MT和LT、PPTA、QPA、内侧滑车倾斜度值及脂肪垫水肿频率显著更高（P<0.001）。女性的ISI、TSA及软骨软化频率显著更高（P<0.001）。
高位髌骨组的LPTA、PPTA、髌腱长度、胫骨结节-滑车沟距离和QPA等主要角度增加。低位髌骨患者的髌骨高度和TGD更高。
