Radiographic measurement of the congruence angle according to Merchant: validity, reproducibility, and limits

Severyns, Mathieu; Mallet, J; Santoni, B; Barnavon, Thomas; Germaneau, Arnaud; Vendeuvre, Tanguy; Dramé, Moustapha

doi:10.1186/s43019-023-00175-5

Cited by 4 publications

(2 citation statements)

References 25 publications

(28 reference statements)

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“…The congruence angle is the angle between the line and the bisector of the trochlear groove angle. This angle is negative on the medial side of the bisector and positive on the lateral side [23] (Fig. 2b).…”

Section: Patellofemoral Alignmentmentioning

confidence: 90%

The larger patellar tilt angle and lower intercondylar notch angle might increase posterior cruciate ligament injury risk: a retrospective comparative study

Huo,

Hao,

Fan

et al. 2023

Preprint

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Background: Posterior cruciate ligament (PCL) injuries are common ligament injuries of the knee, and previous studies often focused on the associations between the morphology of the knee and PCL injuries. Studies on the correlation between PCL injuries and patellofemoral alignment are limited. Methods: This retrospective study included 92 patients with PCL injured and 92 patients with PCL intact. Measurement parameters were compared between the two groups, including patellar tilt angle, congruence angle, patellar height, hip-knee-ankle angle, lateral trochlear inclination,femoral condyle ratio, bicondylar width, intercondylar notch width and index, notch angle, trochlear facet asymmetry, and trochlear sulcus depth and angle. Independent risk factors associated with PCL injuries were identified by logistic regression analyses. Results: In the PCL injured group, the patellar tilt angle was significantly larger (13.19 ± 5.90° vs. 10.02 ± 4.95°, P = 0.04); the intercondylar notch angle was significantly lower (60.97 ± 7.83° vs. 67.01 ± 6.00°, P = 0.004); the medial and lateral femoral condyle ratio were significantly larger (0.63 ± 0.64 vs. 0.60 ± 0.56, P = 0.031; 0.65 ± 0.60 vs. 0.58 ± 0.53, P = 0.005) than in the PCL intact group. There were 11 patients with patellar dislocation in the PCL injured group, accounting for 12%. In these patients, the patellar height was higher (1.39 ± 0.17 vs. 1.09 ± 0.25, P = 0.009); the trochlear sulcus angle was larger (157.70 ± 8.7 vs. 141.80 ± 8.78, P < 0.001); and the trochlear sulcus depth was shallower (3.10 ± 1.20 vs. 5.11 ± 1.48, P = 0.003) than those in the patients without patellar dislocation. Multivariate analyses showed that patellar tilt angle (each increase 1 degree, OR = 1.14) and intercondylar notch angle (each increase 1 degree, OR = 0.90) were independent risk factors for PCL injuries. Conclusion: The patients with PCL injuries had larger patellar tilt angles, lower intercondylar notch angles, and longer posterior femoral condyles than patients with PCL intact. The larger patellar tilt angle and lower intercondylar notch angle might be risk factors for PCL injuries.

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Section: Patellofemoral Alignmentmentioning

confidence: 90%

The larger patellar tilt angle and lower intercondylar notch angle might increase posterior cruciate ligament injury risk: a retrospective comparative study

Huo,

Hao,

Fan

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…An evaluation of radiographic parameters in the management of knee disorders and injuries is essential for treatment planning and outcome assessment. This applies not only to osteoarthritis, but also encompasses cases involving fractures, cartilage lesions, ligament injuries, and meniscus tears [1][2][3][4][5][6][7][8].…”

mentioning

confidence: 99%

The Posterior Tibial Slope Affects the Measurement Reliability Regarding the Radiographic Parameter of the Knee

Lee,

Yoo,

Kwak

et al. 2023

Preprint

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Background Posterior tibial slope (PTS) exhibits considerable variability among individuals and is anticipated to influence the accuracy of radiographic measurements related to the knee. Despite this potential impact, there is a lack of prior research investigating how PTS affects the accuracy of these measurements. Therefore, this study aimed to investigate the effect of PTS on the measurement reliability regarding the radiographic parameter of the knee. Methods The medical records of patients who took full-length anteroposterior radiographs of the lower limb between January 2020 and June 2022 were evaluated retrospectively. Radiographic parameters related to the knee joint characteristics such as osteoarthritis grade, hip-knee-ankle angle, weight-bearing line ratio, medial proximal tibial angle (MPTA), lateral distal femoral angle, joint-line convergence angle (JLCA), and PTS were measured. Subjects were classified into 3 groups according to PTS (group A, PTS < 4°; group B, PTS ≥ 4° and < 8°; group C, PTS ≥ 8°), and the measurement reliability for the radiographic variables mentioned above was compared between groups. The intra- and inter-observer agreements were assessed using the kappa coefficients, intra-class correlation coefficients (ICC), and Bland-Altman plots. Results A total of 175 limbs (86 patients) were included in this study. As the intra- and inter-observer reliability for PTS ranged over 0.9, grouping was performed based on the average of the measured PTSs. In the 3-group comparison of measurement reliability for radiographic parameters, the inter-observer reliability of the MPTA and JLCA decreased as the PTS increased (ICCs for MPTA in Groups A, B, and C: 0.889, 0.796, and 0.790, respectively; ICCs for JLCA in Groups A, B and C: 0.916, 0.859, and 0.843, respectively), whereas there were no remarkable differences in other variables. Similar trends were observed in the comparisons of intra-observer reliability. Additional Bland-Altman plots also showed consistent results. Conclusion The larger the PTS, the lower the measurement reliability regarding the radiographic parameters of the knee that includes the joint line, such as MPTA and JLCA. Since accurate identification of the joint line of the knee is occasionally challenging in patients with a relatively large PTS, care should be exercised when measuring these radiographic parameters.

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The larger patellar tilt angle and lower intercondylar notch angle might increase posterior cruciate ligament injury risk: a retrospective comparative study

Huo,

Hao,

Fan

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Posterior cruciate ligament (PCL) injuries are common ligament injuries of the knee, and previous studies often focused on the associations between the morphology of the knee and PCL injuries. Studies on the correlation between PCL injuries and patellofemoral alignment are limited. Methods This retrospective study included 92 patients with PCL injured and 92 patients with PCL intact. Measurement parameters were compared between the two groups, including patellar tilt angle, congruence angle, patellar height, hip-knee-ankle angle, lateral trochlear inclination, femoral condyle ratio, bicondylar width, intercondylar notch width and index, notch angle, trochlear facet asymmetry, and trochlear sulcus depth and angle. Independent risk factors associated with PCL injuries were identified by logistic regression analyses. Results In the PCL injured group, the patellar tilt angle was significantly larger (13.19 ± 5.90° vs. 10.02 ± 4.95°, P = 0.04); the intercondylar notch angle was significantly lower (60.97 ± 7.83° vs. 67.01 ± 6.00°, P = 0.004); the medial and lateral femoral condyle ratio were significantly larger (0.63 ± 0.64 vs. 0.60 ± 0.56, P = 0.031; 0.65 ± 0.60 vs. 0.58 ± 0.53, P = 0.005) than in the PCL intact group. There were 11 patients with patellar dislocation in the PCL injured group, accounting for 12%. In these patients, the patellar height was higher (1.39 ± 0.17 vs. 1.09 ± 0.25, P = 0.009); the trochlear sulcus angle was larger (157.70 ± 8.7° vs. 141.80 ± 8.78°, P < 0.001); and the trochlear sulcus depth was shallower (3.10 ± 1.20mm vs. 5.11 ± 1.48mm, P = 0.003) than those in the patients without patellar dislocation. Multivariate analyses showed that patellar tilt angle (each increase 1 degree, OR = 1.14) and intercondylar notch angle (each increase 1 degree, OR = 0.90) were independent risk factors for PCL injuries. Conclusion The patients with PCL injuries had larger patellar tilt angles, lower intercondylar notch angles, and longer posterior femoral condyles than patients with PCL intact. The larger patellar tilt angle and lower intercondylar notch angle might be risk factors for PCL injuries.

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Radiographic measurement of the congruence angle according to Merchant: validity, reproducibility, and limits

Cited by 4 publications

References 25 publications

The larger patellar tilt angle and lower intercondylar notch angle might increase posterior cruciate ligament injury risk: a retrospective comparative study

The larger patellar tilt angle and lower intercondylar notch angle might increase posterior cruciate ligament injury risk: a retrospective comparative study

The Posterior Tibial Slope Affects the Measurement Reliability Regarding the Radiographic Parameter of the Knee

The larger patellar tilt angle and lower intercondylar notch angle might increase posterior cruciate ligament injury risk: a retrospective comparative study

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