Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing

Akşahin, Ertuğrul; Yılmaz, Serdar; Karasoy, İsmail; Duran, Semra; Yüksel, Halil Yalçın; Doğan, Özgür; Yıldırım, Ahmet; Biçimoğlu, Ali

doi:10.1007/s00167-015-3533-8

Cited by 12 publications

(37 citation statements)

References 29 publications

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“…To the best of our knowledge, it was the first study analysing the patellofemoral joint alignment from the sagittal plane point of view in patients with anterior knee pain. The main difference between the findings of this study [2] and the previous study is that, although the P-PT angle was increased in the knees of patients suffering from anterior knee pain following tibial nailing with respect to their normal side, it was found to be lower in patients with chondromalacia patella with respect to the control group. Patellar flexion in the sagittal plane is a natural component of patellofemoral tracking in the sagittal plane [33,39].…”

Section: Discussioncontrasting

confidence: 99%

“…In our previous report, the P-PT angle was used to analyse sagittal plane patellofemoral alignment. In these reports [2], it was revealed that the changes in the P-PT angle were correlated…”

Section: Discussionmentioning

confidence: 95%

“…The purposes of this study are: (1) to evaluate sagittal plane alignment in patients with chondromalacia patella via magnetic resonance imaging (MRI); (2) to analyse the relationship between the location of the patellar cartilaginous lesion and sagittal alignment; and (3) to investigate the relationship between the sagittal plane malalignment and patellofemoral loadings using finite element analysis. In the current study, it was hypothesized that the malalignment of the patella in the sagittal plane was related to chondromalacia patellae and this causes supraphysiological loadings on the patellofemoral joint.…”

Section: Introductionmentioning

confidence: 99%

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Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Akşahin¹,

Aktekin

Kocadal³

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Akşahin¹,

Aktekin

Kocadal³

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…Song et al found that the knee ROM was significantly associated with the severity of knee pain [22]. Moreover, Aksahin et al [26] found that the damage to quadriceps might worsen the patellar tilt due to the sagittal patellar tilt and quadriceps hypotrophy after tibial nailing, besides, the displacement of patella might have a negative impact on the knee function. Therefore, much attention must be paid to minimize the damage to quadriceps, especially in SP IMN insertion.…”

Section: Discussionmentioning

confidence: 99%

Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing: a retrospective cohort study

Cui

Hua

Schmidutz

et al. 2019

BMC Musculoskelet Disord

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BackgroundTibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach.MethodsRetrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss.ResultsA total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score (P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain (P = 0.57), the stand and walk (P = 0.54), the need for walking stick (P = 0.60) and extension lag (P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group (P = 0.04) suggesting a higher ROM.ConclusionsBoth SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.

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“…However, the sensitivity, specificity, and AUC of the cutoff value is relatively lower (sensitivity: 70.3%, specificity: 57.6%, AUC: 0.696) to be used generally. Furthermore, to the best of our knowledge, there was no previous study to determine the PPTA cutoff value in the disease groups and some previous studies reported the normal mean PPTA value as 145.1° [ 3 , 20 ]. Further studies are needed to determine the normal value and statistically significant cutoff value of PPTA.…”

Section: Discussionmentioning

confidence: 99%

Patella-patellar tendon angle in relation to the medial patellar plica syndrome, chondromalacia patella, and infrapatellar fat pad syndrome

Kim

Lee

et al. 2022

PLoS ONE

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The patella-patellar tendon angle (PPTA) assessing the sagittal patellar tilt was reported to be related with anterior knee pain. Herein, clinical effect of PPTA in patients with medial patellar plica (MPP) syndrome, chondromalacia patella, and infrapatellar fat pad (IPFP) syndrome, the most common causes of anterior knee pain, was evaluated. In this retrospective study, 156 patients with anterior knee pain who underwent magnetic resonance imaging (MRI) and arthroscopic surgery that confirmed isolated MPP syndrome, chondromalacia patella, or IPFP syndrome from June 2011 to January 2021 were included in the study group and 118 patients without knee pathology on MRI during the same period were included in the control group. The PPTA was measured on knee MRI and compared between the two groups. A receiver operating characteristic (ROC) analysis was used to evaluate the value of PPTA for predicting the risk of patellofemoral joint disorder. The mean PPTA was significantly smaller in study group (138.1 ± 4.2°) than control group (142.1 ± 4.3°) (p < 0.001). However, there was no significant difference in PPTA among the patients with MPP syndrome, chondromalacia patella, and IPFP syndrome. Furthermore, the ROC analysis revealed that the area under curve, sensitivity, and specificity for predicting the risk of patellofemoral joint disorders were 0.696, 70.3% and 57.6%, respectively, at a PPTA cutoff of 138.3°. Therefore, the smaller PPTA may be associated with MPP syndrome, chondromalacia patella, and IPFP syndrome. Furthermore, PPTA could be a predictive factor for the risk of patellofemoral joint disease in patients with anterior knee pain.

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Sagittal patellar tilt and concomitant quadriceps hypotrophy after tibial nailing

Cited by 12 publications

References 29 publications

Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Sagittal plane tilting deformity of the patellofemoral joint: a new concept in patients with chondromalacia patella

Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing: a retrospective cohort study

Patella-patellar tendon angle in relation to the medial patellar plica syndrome, chondromalacia patella, and infrapatellar fat pad syndrome

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