Effects of upright weight bearing and the knee flexion angle on patellofemoral indices using magnetic resonance imaging in patients with patellofemoral instability

2015 ◽  
Vol 25 (8) ◽  
pp. 2405-2413 ◽  
Author(s):  
Christoph Becher ◽  
Benjamin Fleischer ◽  
Marten Rase ◽  
Thees Schumacher ◽  
Max Ettinger ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Flexion ◽  
Weight Bearing ◽  
Patellofemoral Instability ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Resonance Imaging ◽  
Patellofemoral Indices

Magnetic Resonance Imaging Analysis of Rotational Alignment in Patients With Patellar Dislocations

2012 ◽  
Vol 41 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Gerd Diederichs ◽  
Torsten Köhlitz ◽  
Evgenios Kornaropoulos ◽  
Markus O. Heller ◽  
Bernd Vollnberg ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
Patellar Dislocation ◽  
Patellofemoral Instability ◽  
Resonance Imaging ◽  
Tibial Torsion ◽  
Limb Alignment ◽  
Femoral Antetorsion ◽  
Rotational Limb Alignment

Background: The role of anatomic risk factors in patellofemoral instability is not yet fully understood, as they have been observed in patients either alone or in combination and in different degrees of severity. Purpose: To prospectively analyze rotational limb alignment in patients with patellofemoral instability and in controls using magnetic resonance imaging (MRI). Study Design: Cross-sectional study; Level of evidence, 3. Methods: Thirty patients (mean age, 22.9 y; range, 12-41 y) with a history of patellar dislocation and 30 age- and sex-matched controls (mean age, 25.2 y; range, 16-37 y) were investigated. The patients underwent MRI of the leg at 1.5 T using a peripheral angiography coil and a T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) sequence for measuring femoral antetorsion, tibial torsion, knee rotation, and mechanical axis deviation (MAD). The mean values of these parameters were compared between patients and controls. In addition, the patients underwent an assessment to determine the influence of rotational limb alignment on lateral trochlear inclination, trochlear facet asymmetry, trochlear depth, Insall-Salvati index, and tibial tuberosity–trochlear groove distance. Results: Patients had 1.56-fold higher mean femoral antetorsion (20.3° ± 10.4° vs 13.0° ± 8.4°; P < .01) and 1.6-fold higher knee rotation (9.4° ± 5.0° vs 5.7° ± 4.3°; P < .01) compared with controls. Moreover, patients had 2.9 times higher MAD (0.81 ± 0.75 mm vs −0.28 ± 0.87 mm; P < .01). Differences in tibial torsion were not significant. Also, there were no significant correlations between parameters of rotational alignment and standard anatomic risk factors. Conclusion: Our results suggest that some patients with nontraumatic patellar instability have greater internal femoral rotation, greater knee rotation, and a tendency for genu valgum compared with healthy controls. Rotational malalignment may be a primary risk factor in patellar dislocation that has so far been underestimated.

The Difference between Computed Tomography and Magnetic Resonance Imaging Measurements of Tibial Tubercle–Trochlear Groove Distance for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-analysis

2019 ◽  
Vol 33 (08) ◽  
pp. 768-776 ◽  
Author(s):  
Si Heng Sharon Tan ◽  
Beatrice Ying Lim ◽  
Kiat Soon Jason Chng ◽  
Chintan Doshi ◽  
Francis K.L. Wong ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Patellofemoral Instability ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Resonance Imaging ◽  
The Mean ◽  
Ct And Mri

AbstractThe tibial tubercle–trochlear groove (TT–TG) distance was originally described for computed tomography (CT) but has recently been used on magnetic resonance imaging (MRI) without sufficient evidence demonstrating its validity on MRI. The current review aims to evaluate (1) whether there is a difference in the TT–TG distances measured using CT and MRI, (2) whether both the TT–TG distances measured using CT and MRI could be used to differentiate between patients with or without patellofemoral instability, and (3) whether the same threshold of 15 to 20 mm can be applied for both TT–TG distances measured using CT and MRI. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRSIMA) guidelines. All studies that compared TT–TG distances either (1) between CT and MRI or (2) between patients with and without patellofemoral instability were included. A total of 23 publications were included in the review. These included a total of 3,040 patients. All publications reported the TT–TG distance to be greater in patients with patellofemoral instability as compared to those without patellofemoral instability. This difference was noted for both TT–TG distances measured on CT and on MRI. All publications also reported the TT–TG distance measured on CT to be greater than that measured on MRI (mean difference [MD] = 1.79 mm; 95% confidence interval [CI]: 0.91–2.68). Pooling of the studies revealed that the mean TT–TG distance for the control group was 12.85 mm (95% CI: 11.71–14.01) while the mean TT–TG distance for patients with patellofemoral instability was 18.33 mm (95% CI: 17.04–19.62) when measured on CT. When measured on MRI, the mean TT–TG distance for the control group was 9.83 mm (95% CI: 9.11–10.54), while the mean TT–TG distance for patients with patellofemoral instability was 15.33 mm (95% CI: 14.24–16.42). Both the TTTG distances measured on CT and MRI could be used to differentiate between patients with and without patellofemoral instability. Patients with patellofemoral instability had significantly greater TT–TG distances than those without. However, the TT–TG distances measured on CT were significantly greater than that measured on MRI. Different cut-off values should, therefore, be used for TT–TG distances measured on CT and on MRI in the determination of normal versus abnormal values. Pooling of all the patients included in the review then suggest for 15.5 ± 1.5 mm to be used as the cut off for TT–TG distance measured on CT, and for 12.5 ± 2 mm to be used as the cut-off for TT–TG distance measured on MRI. The Level of evidence for this study is IV.

Dynamic measurement of patello-femoral joint alignment using weight-bearing magnetic resonance imaging (WB-MRI)

2015 ◽  
Vol 84 (12) ◽  
pp. 2571-2578 ◽  
Author(s):  
Silvia Mariani ◽  
Alice La Marra ◽  
Francesco Arrigoni ◽  
Stefano Necozione ◽  
Alessandra Splendiani ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Weight Bearing ◽  
Dynamic Measurement ◽  
Resonance Imaging

scholarly journals Patellofemoral Instability: Evaluation by Magnetic Resonance Imaging

2013 ◽  
Vol 48 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Patrícia Martins e Souza ◽  
Marcelo Sadock de Sá Gabetto ◽  
Marcelo Ganem Serrão ◽  
Luiz Antônio Martins Vieira ◽  
Diogo Cals de Oliveira
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Patellofemoral Instability ◽  
Resonance Imaging

scholarly journals Weight-Bearing Knee Flexion Angle Better Correlates with Patient-Reported Outcome Measures Than Non-Weight-Bearing Condition in Total Knee Arthroplasty: A Three-Dimensional Analysis Study

2021 ◽  
Author(s):  
Tomofumi Kage ◽  
Hiroshi Inui ◽  
Tetsuya Tomita ◽  
Takaharu Yamazaki ◽  
Shuji Taketomi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Patient Reported Outcome Measures ◽  
Flexion Angle ◽  
3D Analysis ◽  
Knee Flexion Angle ◽  
Angular Difference ◽  
Functional Activities ◽  
Patient Reported

Abstract Background: This study aims to elucidate and compare the relationship between the knee flexion angle and patient-reported outcome measures (PROM) in both non-weight-bearing (NWB) and weight-bearing (WB) conditions. Methods: This retrospective cohort study included 61 knees (47 patients) who underwent total knee arthroplasty. The knee flexion angle was measured by three conditions: NWB in manual goniometer, NWB in fluoroscopic three-dimensional (3D) analysis and WB in the fluoroscopic 3D analysis. The PROM was evaluated by postoperative 2011 Knee Society Score (2011 KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Correlations between the knee flexion angle and PROM was analyzed using Spearman’s correlation coefficient. Additionally, whether the angular difference between NWB and WB correlated with the PROM or not was evaluated. Results: The NWB knee flexion angle in a goniometer, NWB in 3D analysis, and WB in 3D analysis were 124.6° ± 8.4°, 118.0° ± 10.5°, and 109.5° ± 13.3°, respectively. The angular difference was 8.5° ± 12.8°. No PROM correlation existed in NWB using a goniometer. Moreover, significant positive correlations in 2011 KSS symptoms (r = 0.35) and 2011 KSS functional activities (r = 0.27) were noted in NWB using 3D analysis. Significant positive correlations existed in 2011 KSS symptoms (r = 0.32), 2011 KSS functional activities (r = 0.57), KOOS pain (r = 0.37), KOOS activity of daily living (ADL; r = 0.45), KOOS sports (r = 0.42), and KOOS quality of life (r = 0.36) in WB using 3D analysis. Significant negative correlations were noted in 2011 KSS functional activities (r = −0.45), KOOS ADL (r = −0.30), and KOOS sports (r = −0.38) in angular difference. Conclusions: The WB knee flexion angle better correlated with PROM compared with NWB by evaluation of 3D analysis. The larger the angular difference existed between NWB and WB, the lower the PROM score.

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