Knee Imaging Techniques and Normal Anatomy

Madoff, Samuel D.; Burak, Jarett S.; Math, Kevin R.; Walz, Daniel M.

doi:10.1016/b978-1-4377-1503-3.00005-6

Cited by 1 publication

(1 citation statement)

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“…In a neutrally aligned knee, the mechanical axis passes between the tibial spines (in valgus alignment it passes laterally), and both the mechanical lateral distal femoral angle and medial proximal tibial angle measure 87° with normative ranges of 85° to 90°. The lateral radiographic view at 30° knee flexion 32 is critical for assessment of patellar height, which may be measured using Caton-Deschamps index, 33 which has been shown to have the best interobserver reliability and is least affected by skeletal maturity. 33 , 34 The Merchant view, 35 , 36 with the patient supine, knee in 45° flexion, and radiograph beam angled 30° from horizontal (aiming cranial to caudal), allows assessment of patellofemoral morphology and tracking at low flexion angle, 31 as well as measurement of sulcus angle and patellar tilt.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Implant-Mediated Guided Growth for Coronal Plane Angular Deformity in the Pediatric Patient with Patellofemoral Instability

Lin

Thacher

Apostolakos

et al. 2021

Arthroscopy Techniques

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Pediatric patellofemoral instability is a complex problem, for which there are several anatomic risk factors. Coronal plane malalignment (i.e., genu valgum) is one cause of patellofemoral instability, and treatment of genu valgum has been associated with improved patellofemoral stability. Coronal plane angular deformity correction, typically achieved by distal femoral osteotomy in the adult population, can be achieved with less invasive surgical techniques in pediatric patients using implant-mediated guided growth. By temporarily tethering one side of an open physis to generate differential growth in the coronal plane, valgus malalignment can be corrected. We present our technique for medial distal femoral implant-mediated guided growth using tension band plating for treatment of pediatric patellofemoral instability associated with genu valgum. This technique is minimally invasive, has a low complication rate, and in conjunction with conventional treatment can reduce the risk of recurrent instability.

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