Atualização em instabilidade patelar

Severino, Nilson Roberto; Severino, Fabrício Roberto; Camargo, Osmar Pedro Arbix de; Guglielmetti, Luiz Gabriel Betoni; Oliveira, Victor Marques de; Cury, Ricardo de Paula Leite

doi:10.1055/s-0040-1713389

Cited by 4 publications

(6 citation statements)

References 53 publications

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“…Along with magnetic resonance imaging (MRI) and X‐ray, computed tomography (CT) scans remain a standardized radiographic tool to assess and quantify patellofemoral alignment, showing good reliability [1, 11, 27, 48]. However, insufficient data for cutoff values or thresholds of anatomic factors based on CT images have been reported [18, 42]. Although demographic risk factors (e.g., age and sex) contribute to patellofemoral instability [5, 42], few previous studies have assessed patellofemoral morphology and anatomic risk factors within pair‐matched groups based on age and sex.…”

Section: Introductionmentioning

confidence: 99%

“…However, insufficient data for cutoff values or thresholds of anatomic factors based on CT images have been reported [18, 42]. Although demographic risk factors (e.g., age and sex) contribute to patellofemoral instability [5, 42], few previous studies have assessed patellofemoral morphology and anatomic risk factors within pair‐matched groups based on age and sex.…”

Section: Introductionmentioning

confidence: 99%

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Sulcus depth, congruence angle, Wiberg index, TT-TG distance, and CDI are strong predictors of recurrent patellar dislocation

Chen

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo characterize patellofemoral morphology, determine radiological cutoff values based on computed tomography (CT) images, and clarify predominant anatomic risk factors in young patients with recurrent patellar dislocation (RPD). MethodsA total of 212 knees (age 23.0 ± 5.3 years, female: male = 110:102) with CT‐confirmed RPD were enrolled for analysis. The control group was matched by age and sex (2:1). Patellofemoral and trochlear morphology, patellofemoral alignment, and other parameters were assessed by CT. Standardized methods were used for measurements. Receiver operating characteristic (ROC) curves and the areas under the ROC curve (AUCs) were used to assess accuracy in diagnosing RPD. The index of union (IU) was employed to identify a cutoff value for risk. A binary logistic regression model (Forward, LR) was constructed, and standardized coefficients were calculated to compare the relative strength of different predictors. Factors included in the model were employed to calculate distributions in the studied population. ResultsThe majority of measurements showed a significant difference between the RPD and control groups when comparing mean values. The AUC value was favorable for sulcus depth and significantly better than that for other trochlear morphology parameters (P < 0.0001). Cutoff values were 0.58 for the Wiberg index, 153.3° for the sulcus angle, 3.6 mm for the sulcus depth, 1.94 for the trochlear width ratio, 16.2° for the lateral trochlear inclination, 17.2° for the patellar lateral tilt, 25.5° for the congruence angle, 1.2 for the patellar height [Caton–Deschamps index (CDI)], 6.1° for the knee rotation, and 16.4 mm for the tibial tubercle–trochlear groove (TT‐TG) distance. A binary logistic regression model (χ2 = 20.826, P = 0.008) including the Wiberg index, sulcus depth, congruence angle, patellar height (CDI), and TT‐TG distance was constructed for RPD (P ≤ 0.015), which showed excellent diagnostic performance, as indicated by an AUC of 0.989 (95% CI, 0.979 to 0.998). Sulcus depth showed the strongest relationship with RPD, followed by the congruence angle and Wiberg index, as indicated by the standardized coefficients − 1.43, 1.02, and 0.97, respectively. Eighty‐seven percent of the RPD population had sulcus depth ≤ 3.6 mm. ConclusionsThis study provides a systematic reference of cutoff values based on CT data. The combination of five anatomic risk factors (sulcus depth, congruence angle, Wiberg index, TT‐TG distance, and CDI) may be an excellent predictor of RPD as initial risk assessment. Sulcus depth, as the most frequently observed anatomic risk factor, showed the best diagnostic performance among trochlear morphological parameters and the strongest relationship with RPD, followed by the congruence angle and Wiberg index. In clinical practice, the sulcus depth, congruence angle, Wiberg index, TT‐TG distance, and CDI with the proposed cutoff values can be used in combination to evaluate RPD. When assessing trochlear morphology, sulcus depth is recommended as the best radi...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sulcus depth, congruence angle, Wiberg index, TT-TG distance, and CDI are strong predictors of recurrent patellar dislocation

Chen

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…A literatura diverge; pois autores como Haim et al 32 não registraram diferenças entre os grupos estudados em relação a esta medida. Outros 33,34,35,36,37,38,39,40 Para avaliar a probabilidade de luxação patelar na análise de regressão logística, de igual forma, considerando como variável dependente a IPO (comparada a IPP) e as medidas tomográficas como variáveis independentes observou-se que as medidas do ângulo do sulco troclear não foram significantes, não podendo ser consideradas para probabilidade de luxação patelar em femoropatelares instáveis.…”

Section: Resultsunclassified

Risco de luxação patelar em joelhos com instabilidade patelar potencial - analise do ângulo do sulco troclear / Risk of patellar luxation in knees with potential patellar instability – troclearsulcusangle analysis

Schueda¹,

Cohen²,

Cat³

et al. 2021

BJDV

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Avaliar a importância etiológica do sulco troclear nas Instabilidades Patelares e qual sua significância na Luxação da patela. Método: 1.705 medidas tomográficas pelo Protocolo da Escola Lyonesade 921 indivíduos foram coletadas. 363 (39,4%) do gênero masculino e 558 (60,6%) do gênero feminino com média de idade de 33,7 ± 11,2 anos. Distribuídos em 4 grupos: Normal -N (n = 87) joelhos de indivíduos assintomáticos para os quais foram tomadas as medidas tomográficas protocolares. Grupo Síndrome Patelar Dolorosa-SPD (n=596) pacientes com clínica de dor ou falseamento e ausência de critérios maiores positivos nas medidas tomográficas.Grupo Instabilidade Patelar Potencial-IPP (n=1.070). Foram considerados os pacientes com pelo menos um dos critérios maiores positivos (AST = Ângulo do sulco troclear, TA-GT = Distância da tuberosidade anterior à garganta da tróclea, ISC = Altura patelar e BP = Báscula patelar) nas medidas tomográficas. Os pacientes com luxação da patela formaram o Grupo Instabilidade Patelar Objetiva -IPO (n = 39). A estimativa da diferença entre médias realizada pelo teste t de Student, a diferença entre medianas, para variáveis de distribuição assimétrica realizada pelo teste de Mann-Whitney e a comparação das medidas entre o grupos realizada pela Análise da Variância (ANOVA) e Análise da Variância de Kruskal-Wallis.Curvas ROC foram construídas para estimar os pontos de corte e respectivos índices de sensibilidade e especificidade em cada grupo.A probabilidade de luxação foi estimada por meio de regressão logística univariada. Resultados:Observou-se prevalência do desalinhamento patelar em mulheres (58,7% no grupo IPP e 64,7% no Grupo IPO) com média de idade de 33,6 + 11,2 anos (16 a 72 anos) no grupo IPP e de 27,9 + 13,0 anos (16 a 75 anos) no grupo IPO observou-se diferença dos grupos normal e SPD para os grupos IPP e IPO, mas não entre IPP e IPO traduzindo que tal ângulo leva a instabilidade, mas por si só não foi preditivo de luxação patelar. No presente estudo, os resultados indicam ser um dado anatômico importante na gênese da Instabilidade Femoropatelar visto representar a conseqüência femoral da patologia. Quanto a probabilidade de luxação patelar as medidas do ângulo do sulco troclear não foram significantes. Conclusão: O Ângulo do Sulco Troclear está entre os mais sensíveis e específicos para confirmar o diagnóstico de instabilidade patelar, masnão forneceu prognóstico para a luxação patelar.

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“…The authors reviewed existing research and theories on the topic, through a systematic literature review, and a bibliographic and documental survey [1] [2].…”

Section: Acknowledgmentmentioning

confidence: 99%

Energy and Covid 19

Ferrari

2022

Braz. J. Rad. Sci.

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Pandemics reverberated their times, changing social and economic contexts, prompting, and redirecting changes in social ties, business, and education, restructuring the world that generated them. In this context, this study aims to assess the impact of the COVID-19 pandemic on the global energy matrix, supported by an analysis of consumption, demand, and GDP from January 2019 to June 2021. The energy balance showed variations in this period, with impacts on the environment. We will assess whether the changes will be lasting.

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Atualização em instabilidade patelar

Cited by 4 publications

References 53 publications

Sulcus depth, congruence angle, Wiberg index, TT-TG distance, and CDI are strong predictors of recurrent patellar dislocation

Sulcus depth, congruence angle, Wiberg index, TT-TG distance, and CDI are strong predictors of recurrent patellar dislocation

Risco de luxação patelar em joelhos com instabilidade patelar potencial - analise do ângulo do sulco troclear / Risk of patellar luxation in knees with potential patellar instability – troclearsulcusangle analysis

Energy and Covid 19

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