Patellar Tendon-Trochlear Groove Angle Measured on a Single Computed Tomography Slice of the Distal Femoral Trochlear Groove Is a Reliable Measurement for the Evaluation of Patellar Instability.
Arthroscopy
; 39(5): 1244-1250, 2023 05.
Article
em En
| MEDLINE
| ID: mdl-36526511
ABSTRACT
PURPOSE:
To verify the reliability of patellar tendon-trochlear groove angle (PTTG-A) measured by computed tomography (CT) and the clinical significance in evaluation of patellar instability.METHODS:
A retrospective study of hospitalized patients with knee pain or injury and had knee CT from January 2017 to June 2021 was performed. PTTG-A and tibial tuberosity-trochlear groove (TT-TG) distance were measured on CT. Spearman correlation analysis was analyzed between the 2 measurements. The intraclass correlation coefficient was determined for inter- and intraobserver reproducibility. The capacity of PTTG-A and TT-TG to predict patellar instability was evaluated by the receiver operating characteristic curve. Data from the control group were used to determine the pathologic thresholds and logistic regression analysis.RESULTS:
Included were 113 patients. There were 60 patients with the history of at least 2 episodes of patellar dislocation (study group) and 53 patients without a history of patellar dislocation (control group). The respective PTTG-A and TT-TG distances in the study group (35.2 ± 8.4° and 19.6 ± 4.6 mm) were significantly greater than those of the controls (20.8 ± 5.8° and 13.3 ± 4.5 mm) (P < .001). The correlation between the 2 measurements was strong (r = 0.730, P < .001). The inter- and intraobserver reliability of the PTTG-A were better than TT-TG distance in both groups. The AUC of PTTG-A was greater than that of the TT-TG distance (0.895 vs 0.769, respectively). With the cutoff value of PTTG-A and TT-TG being 26.3° and 16.3 mm, the value of the pathologic threshold of PTTG-A was 30.0°, with a dominance ratio of 16.88 (95% confidence interval 2.88-98.89, P = .002).CONCLUSIONS:
The PTTG-A measured on a single CT slice of the distal femoral trochlear groove is a more reliable measurement than TT-TG distance for the prediction of patellar instability. LEVEL OF EVIDENCE III; A retrospective cohort study.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ligamento Patelar
/
Luxação Patelar
/
Articulação Patelofemoral
/
Instabilidade Articular
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Arthroscopy
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2023
Tipo de documento:
Article