Limits...
Comparison of Radiological Parameters between Normal and Patellar Dislocation Groups in Korean Population: A Rotational Profile CT-Based Study

View Article: PubMed Central - PubMed

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.

No MeSH data available.


(A) Posterior condylar angle: the angle between the posterior condylar line and the transepicondylar line. (B) Trochlear angle: the angle between the posterior condylar line and a tangential line passing through the anterior aspects of the medial and lateral trochlea. (C) Lateral trochlear inclination: the angle between the posterior condylar line and the lateral trochlear facet. (D) Medial trochlear inclination: the angle the posterior condylar line and the medial trochlear facet. (E) Sulcus angle: the angle between the medial and lateral trochlear facets. (F) Trochlear depth: the inset depth of the trochlear groove relative to the mean of the medial and lateral femoral condyle outsets calculated as [(a−b)+(b−c)]/2. a: lateral facet height, b: medial facet height, c: perpendicular line from the sulcus to the posterior condylar line.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5134791&req=5

f1-ksrr-28-302: (A) Posterior condylar angle: the angle between the posterior condylar line and the transepicondylar line. (B) Trochlear angle: the angle between the posterior condylar line and a tangential line passing through the anterior aspects of the medial and lateral trochlea. (C) Lateral trochlear inclination: the angle between the posterior condylar line and the lateral trochlear facet. (D) Medial trochlear inclination: the angle the posterior condylar line and the medial trochlear facet. (E) Sulcus angle: the angle between the medial and lateral trochlear facets. (F) Trochlear depth: the inset depth of the trochlear groove relative to the mean of the medial and lateral femoral condyle outsets calculated as [(a−b)+(b−c)]/2. a: lateral facet height, b: medial facet height, c: perpendicular line from the sulcus to the posterior condylar line.

Mentions: The trochlear study was conducted on the axial image that best described its anatomy. The best section was considered when the intercondylar notch took an appearance of a rounded roman arch. We studied 7 parameters in trochlear morphology (Fig. 1): 1) posterior condylar angle, 2) trochlear angle, 3) lateral trochlear inclination, 4) medial trochlear inclination, 5) sulcus angle, 6) trochlear depth, and 7) trochlear facet asymmetry defined as the ratio of the medial trochlear facet width to the lateral trochlear facet width.


Comparison of Radiological Parameters between Normal and Patellar Dislocation Groups in Korean Population: A Rotational Profile CT-Based Study
(A) Posterior condylar angle: the angle between the posterior condylar line and the transepicondylar line. (B) Trochlear angle: the angle between the posterior condylar line and a tangential line passing through the anterior aspects of the medial and lateral trochlea. (C) Lateral trochlear inclination: the angle between the posterior condylar line and the lateral trochlear facet. (D) Medial trochlear inclination: the angle the posterior condylar line and the medial trochlear facet. (E) Sulcus angle: the angle between the medial and lateral trochlear facets. (F) Trochlear depth: the inset depth of the trochlear groove relative to the mean of the medial and lateral femoral condyle outsets calculated as [(a−b)+(b−c)]/2. a: lateral facet height, b: medial facet height, c: perpendicular line from the sulcus to the posterior condylar line.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134791&req=5

f1-ksrr-28-302: (A) Posterior condylar angle: the angle between the posterior condylar line and the transepicondylar line. (B) Trochlear angle: the angle between the posterior condylar line and a tangential line passing through the anterior aspects of the medial and lateral trochlea. (C) Lateral trochlear inclination: the angle between the posterior condylar line and the lateral trochlear facet. (D) Medial trochlear inclination: the angle the posterior condylar line and the medial trochlear facet. (E) Sulcus angle: the angle between the medial and lateral trochlear facets. (F) Trochlear depth: the inset depth of the trochlear groove relative to the mean of the medial and lateral femoral condyle outsets calculated as [(a−b)+(b−c)]/2. a: lateral facet height, b: medial facet height, c: perpendicular line from the sulcus to the posterior condylar line.
Mentions: The trochlear study was conducted on the axial image that best described its anatomy. The best section was considered when the intercondylar notch took an appearance of a rounded roman arch. We studied 7 parameters in trochlear morphology (Fig. 1): 1) posterior condylar angle, 2) trochlear angle, 3) lateral trochlear inclination, 4) medial trochlear inclination, 5) sulcus angle, 6) trochlear depth, and 7) trochlear facet asymmetry defined as the ratio of the medial trochlear facet width to the lateral trochlear facet width.

View Article: PubMed Central - PubMed

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.

No MeSH data available.