Patellar alignment evaluated by MRI

Muellner, Thomas; Funovics, Martin; Nikolic, Ajsa; Metz, V.; Schabus, R.; Vécsei, V.

doi:10.3109/17453679808997784

Cited by 23 publications

(8 citation statements)

References 12 publications

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“…An increase in the femoral sulcus angle corresponded to a shallower articular surface whereas a decrease in this angle corresponded to a deeper articular surface. Both the lateral condyle-patella angle and femoral sulcus angle were measured at mid-patella level [21], determined by counting all the slices that go through the patella and using the middle slice. In the case when there is an even number of slices, the two middle slices are measured and averaged.…”

Section: Methodsmentioning

confidence: 99%

The associations between indices of patellofemoral geometry and knee pain and patella cartilage volume: a cross-sectional study

Tanamas

Teichtahl

Wluka

et al. 2010

BMC Musculoskelet Disord

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BackgroundWhilst patellofemoral pain is one of the most common musculoskeletal disorders presenting to orthopaedic clinics, sports clinics, and general practices, factors contributing to its development in the absence of a defined arthropathy, such as osteoarthritis (OA), are unclear.The aim of this cross-sectional study was to describe the relationships between parameters of patellofemoral geometry (patella inclination, sulcus angle and patella height) and knee pain and patella cartilage volume.Methods240 community-based adults aged 25-60 years were recruited to take part in a study of obesity and musculoskeletal health. Magnetic resonance imaging (MRI) of the dominant knee was used to determine the lateral condyle-patella angle, sulcus angle, and Insall-Salvati ratio, as well as patella cartilage and bone volumes. Pain was assessed by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) VA pain subscale.ResultsIncreased lateral condyle-patella angle (increased medial patella inclination) was associated with a reduction in WOMAC pain score (Regression coefficient -1.57, 95% CI -3.05, -0.09) and increased medial patella cartilage volume (Regression coefficient 51.38 mm3, 95% CI 1.68, 101.08 mm3). Higher riding patella as indicated by increased Insall-Salvati ratio was associated with decreased medial patella cartilage volume (Regression coefficient -3187 mm3, 95% CI -5510, -864 mm3). There was a trend for increased lateral patella cartilage volume associated with increased (shallower) sulcus angle (Regression coefficient 43.27 mm3, 95% CI -2.43, 88.98 mm3).ConclusionThese results suggest both symptomatic and structural benefits associated with a more medially inclined patella while a high-riding patella may be detrimental to patella cartilage. This provides additional theoretical support for the current use of corrective strategies for patella malalignment that are aimed at medial patella translation, although longitudinal studies will be needed to further substantiate this.

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Section: Methodsmentioning

confidence: 99%

The associations between indices of patellofemoral geometry and knee pain and patella cartilage volume: a cross-sectional study

Tanamas

Teichtahl

Wluka

et al. 2010

BMC Musculoskelet Disord

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“…Very few studies have evaluated PF alignment by magnetic resonance imaging (MRI) [19-21]. Muellner and colleagues [19] performed measurements analogous to those used in X-ray evaluation with MRI images obtained with knees flexed to 20° and 45°.…”

Section: Introductionmentioning

confidence: 99%

“…Muellner and colleagues [19] performed measurements analogous to those used in X-ray evaluation with MRI images obtained with knees flexed to 20° and 45°. Knee flexion allows the evaluation of PF relations when the patella is located in opposition to the femoral trochanteric sulcus.…”

Section: Introductionmentioning

confidence: 99%

The association between patellar alignment on magnetic resonance imaging and radiographic manifestations of knee osteoarthritis

et al. 2007

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The aim of our study was to evaluate the association between patellar alignment by using magnetic resonance imaging images and radiographic manifestations of patello-femoral osteoarthritis (OA). Subjects were recruited to participate in a natural history study of symptomatic knee OA. We examined the relation of patellar alignment in the sagittal plane (patellar length ratio (PLR)) and the transverse plane (sulcus angle (SA), lateral patellar tilt angle (LPTA), and bisect offset (BO)) to radiographic features of patello-femoral OA, namely joint space narrowing and patellar osteophytes, using a proportional odds logistic regression model while adjusting for age, sex, and bone mass index (BMI). The study sample consisted of 126 males (average age 68.0 years, BMI 31.2) and 87 females (average age 64.7 years, BMI 31.6), 75% of whom had tibiofemoral OA (a Kellgren-Lawrence score of 2 or more). PLR showed a statistically significant association with joint space narrowing and osteophytosis in the lateral compartment. SA showed significant association with medial joint space narrowing and with lateral and medial patellar osteophytosis. LPTA and BO showed significant association with both radiographic indices of the lateral compartment. Clear linear trends were found in association between PLR, LPTA and BO, and with outcomes associated with lateral patello-femoral OA. SA, LPTA, and BO showed linear trends of association with medial joint space narrowing. Results of our study clearly suggest the association between indices of patellar alignment and such features of patello-femoral OA as osteophytosis and joint space narrowing. Additional studies will be required to establish the normal and abnormal ranges of patellar alignment indices and their longitudinal relation to patello-femoral OA.

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“…1,[4][5][6][7][8][9][10][11][12][13] First, the bony contour takes the place of the actual articular surface because articular cartilage cannot be seen by plain radiography or CT. [13][14][15] Secondly, since the midpatellar axial plane is commonly chosen as the cross-sectional plane for evaluation of the trochlea, this location may differ from patient to patient where there are individual differences in the location of the patella in relation to the femur. 7,13,16 Finally, it is difficult to accurately reconstruct the shape of the trochlea from consecutive two dimensional (2D) images alone. 9,13 In an attempt to compensate for these limitations, basic biomechanical studies have directly analysed the shape of the trochlea using cadavers.…”

mentioning

confidence: 99%

“…7,13,16 Finally, it is difficult to accurately reconstruct the shape of the trochlea from consecutive two dimensional (2D) images alone. 9,13 In an attempt to compensate for these limitations, basic biomechanical studies have directly analysed the shape of the trochlea using cadavers. This has provided important basic data which are used in the design of prosthetic joints.…”

mentioning

confidence: 99%

Morphological analysis of the femoral trochlea in patients with recurrent dislocation of the patella using three-dimensional computer models

Yamada¹,

Toritsuka

Yoshikawa³

et al. 2007

The Journal of Bone and Joint Surgery. British volume

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We investigated the three-dimensional morphological differences of the articular surface of the femoral trochlea in patients with recurrent dislocation of the patella and a normal control group using three-dimensional computer models. There were 12 patients (12 knees) and ten control subjects (ten knees). Three-dimensional computer models of the femur, including the articular cartilage, were created. Evaluation was performed on the shape of the articular surface, focused on its convexity, and the proximal and mediolateral distribution of the articular cartilage of the femoral trochlea. The extent of any convexity, and the proximal distribution of the articular cartilage, expressed as the height, were shown by the angles about the transepicondylar axis. The mediolateral distribution of the articular cartilage was assessed by the location of the medial and lateral borders of the articular cartilage. The mean extent of convexity was 24.9 degrees sd 6.7 degrees for patients and 11.9 degrees sd 3.6 degrees for the control group (p < 0.001). The mean height of the articular cartilage was 91.3 degrees sd 8.3 degrees for the patients and 83.3 degrees sd 7.7 degrees for the control group (p = 0.03), suggesting a wider convex trochlea in the patients with recurrent dislocation of the patella caused by the proximally-extended convex area. The lateral border of the articular cartilage of the trochlea in the patients was more laterally located than in the control group. Our findings therefore quantitatively demonstrated differences in the shape and distribution of the articular cartilage on the femoral trochlea between patients with dislocation of the patella and normal subjects.

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Patellar alignment evaluated by MRI

Cited by 23 publications

References 12 publications

The associations between indices of patellofemoral geometry and knee pain and patella cartilage volume: a cross-sectional study

The associations between indices of patellofemoral geometry and knee pain and patella cartilage volume: a cross-sectional study

The association between patellar alignment on magnetic resonance imaging and radiographic manifestations of knee osteoarthritis

Morphological analysis of the femoral trochlea in patients with recurrent dislocation of the patella using three-dimensional computer models

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