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Use of computed tomography to determine the risk of patellar dislocation in 921 patients with patellar instability.

Schueda MA, Astur DC, Bier RS, Bier DS, Astur N, Cohen M - Open Access J Sports Med (2015)

Bottom Line: A cross-sectional study in 921 patients with anterior pain or knee instability of at least 6 months' duration was conducted from July 2001 to December 2009.According to their degree of dislocating patellar dysplasia, the subjects were classified into groups for statistical comparison.There was a statistically significant difference in all measurements when the groups were compared, except for external tibial torsion angle.

View Article: PubMed Central - PubMed

Affiliation: Serviço de Pós Graduação em Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, Brazil.

ABSTRACT
The purpose of this research was to identify reliable tomographic measurements that can detect patellofemoral abnormality and allow quantification of the risk of patellar dislocation in patients with potential patellar instability. A cross-sectional study in 921 patients with anterior pain or knee instability of at least 6 months' duration was conducted from July 2001 to December 2009. All subjects were clinically evaluated and underwent radiography and computed tomography of their knees. According to their degree of dislocating patellar dysplasia, the subjects were classified into groups for statistical comparison. There was a statistically significant difference in all measurements when the groups were compared, except for external tibial torsion angle. The most sensitive and specific measurements for determining patellar instability were the trochlear groove angle, tibial tubercle-trochlear groove distance, average patellar tilt, and average patellar height. Patients with potential patellar instability, increased tibial tubercle-trochlear groove distance, and patellar height, tilt, and deviation measurements had a greater risk for patellar dislocation. The clinical relevance of this study is to determine measurements that are able to tell us about patellar dislocation risk.

No MeSH data available.


Related in: MedlinePlus

Risk of group 3 dislocations according to APD measured. The risk of dislocation increases significantly with measurements over 10 mm. When the APD value is 35 mm, the risk increases by 85%.Abbreviation: APD, average patellar deviation.
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f5-oajsm-6-055: Risk of group 3 dislocations according to APD measured. The risk of dislocation increases significantly with measurements over 10 mm. When the APD value is 35 mm, the risk increases by 85%.Abbreviation: APD, average patellar deviation.

Mentions: Measurements were compared for subjects with potential patellar instability (group 3) and those with objective patellar instability (group 4), and their risk of patellar dislocation was estimated using a multiple logistic regression model, presenting the probability of 0% to 100% occurrence of dislocation in accordance with the CT measurement values, presenting the probability of 0% to 100% occurrence of dislocation in accordance with the CT measurement. Knees with a markedly increased TTTG and patellar height, tilt, and deviation were noted to have a higher risk of patellar dislocation. The probability of dislocation increased with TTTG values >15 mm, reaching 20% if TTTG was >35 mm (Figure 2). Moreover, the risk of dislocation increased significantly with APH measurements >1. The risk of dislocation was about 6% when APH was 1.2, and increased by 30% when APH was 1 (Figure 3). The risk of dislocation also increased when APT was over 30 degrees. When APT was 68.5 degrees, the risk of dislocation increased by 80% (Figure 4). When we considered the APD values, the risk of dislocation increased significantly with measurements over 10 mm. When the APD value was 35 mm, the risk increased by 85% (Figure 5).


Use of computed tomography to determine the risk of patellar dislocation in 921 patients with patellar instability.

Schueda MA, Astur DC, Bier RS, Bier DS, Astur N, Cohen M - Open Access J Sports Med (2015)

Risk of group 3 dislocations according to APD measured. The risk of dislocation increases significantly with measurements over 10 mm. When the APD value is 35 mm, the risk increases by 85%.Abbreviation: APD, average patellar deviation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356681&req=5

f5-oajsm-6-055: Risk of group 3 dislocations according to APD measured. The risk of dislocation increases significantly with measurements over 10 mm. When the APD value is 35 mm, the risk increases by 85%.Abbreviation: APD, average patellar deviation.
Mentions: Measurements were compared for subjects with potential patellar instability (group 3) and those with objective patellar instability (group 4), and their risk of patellar dislocation was estimated using a multiple logistic regression model, presenting the probability of 0% to 100% occurrence of dislocation in accordance with the CT measurement values, presenting the probability of 0% to 100% occurrence of dislocation in accordance with the CT measurement. Knees with a markedly increased TTTG and patellar height, tilt, and deviation were noted to have a higher risk of patellar dislocation. The probability of dislocation increased with TTTG values >15 mm, reaching 20% if TTTG was >35 mm (Figure 2). Moreover, the risk of dislocation increased significantly with APH measurements >1. The risk of dislocation was about 6% when APH was 1.2, and increased by 30% when APH was 1 (Figure 3). The risk of dislocation also increased when APT was over 30 degrees. When APT was 68.5 degrees, the risk of dislocation increased by 80% (Figure 4). When we considered the APD values, the risk of dislocation increased significantly with measurements over 10 mm. When the APD value was 35 mm, the risk increased by 85% (Figure 5).

Bottom Line: A cross-sectional study in 921 patients with anterior pain or knee instability of at least 6 months' duration was conducted from July 2001 to December 2009.According to their degree of dislocating patellar dysplasia, the subjects were classified into groups for statistical comparison.There was a statistically significant difference in all measurements when the groups were compared, except for external tibial torsion angle.

View Article: PubMed Central - PubMed

Affiliation: Serviço de Pós Graduação em Cirurgia do Joelho e Artroscopia do IOT e Traumasports de Joinville, Joinville, Santa Catarina, Brazil.

ABSTRACT
The purpose of this research was to identify reliable tomographic measurements that can detect patellofemoral abnormality and allow quantification of the risk of patellar dislocation in patients with potential patellar instability. A cross-sectional study in 921 patients with anterior pain or knee instability of at least 6 months' duration was conducted from July 2001 to December 2009. All subjects were clinically evaluated and underwent radiography and computed tomography of their knees. According to their degree of dislocating patellar dysplasia, the subjects were classified into groups for statistical comparison. There was a statistically significant difference in all measurements when the groups were compared, except for external tibial torsion angle. The most sensitive and specific measurements for determining patellar instability were the trochlear groove angle, tibial tubercle-trochlear groove distance, average patellar tilt, and average patellar height. Patients with potential patellar instability, increased tibial tubercle-trochlear groove distance, and patellar height, tilt, and deviation measurements had a greater risk for patellar dislocation. The clinical relevance of this study is to determine measurements that are able to tell us about patellar dislocation risk.

No MeSH data available.


Related in: MedlinePlus