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Increased tibial tuberosity torsion has the greatest predictive value in patients with patellofemoral instability compared to other commonly assessed parameters.
Jud, Lukas; Hartmann, Martin; Vlachopoulos, Lazaros; Zimmermann, Stefan M; Ackermann, Jakob; Fucentese, Sandro F.
Afiliação
  • Jud L; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Hartmann M; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Vlachopoulos L; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Zimmermann SM; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Ackermann J; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
  • Fucentese SF; Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Knee Surg Sports Traumatol Arthrosc ; 32(5): 1179-1186, 2024 May.
Article em En | MEDLINE | ID: mdl-38504510
ABSTRACT

PURPOSE:

The multifactorial nature of patellofemoral instability requires a comprehensive assessment of the affected patients. While an association between tibial tuberosity (TT) torsion and patellofemoral instability is known, its specific effect has not yet been investigated. This study investigated the effect of TT torsion on patellofemoral instability.

METHODS:

This retrospective cohort study compared patients who underwent surgical intervention for patellofemoral instability and asymptomatic controls. TT torsion was measured in addition to other commonly assessed risk factors for patellofemoral instability using standardised computed tomography (CT) data of the lower extremities. The diagnostic performances of the assessed parameters were evaluated using receiver operating characteristic curve analysis and odds ratios (ORs) were calculated.

RESULTS:

The patellofemoral instability group consisted of 79 knees, compared to 72 knees in the asymptomatic control group. Both groups differed significantly in all assessed parameters (p < 0.001), except for tibial torsion (n.s.). Among all parameters, TT torsion presented the best diagnostic performance for predicting patellar instability with an area under the curve of 0.95 (95% confidence interval [CI], 0.91-0.98; p < 0.001). A cut-off value of 17.7° yielded a 0.87 sensitivity and 0.89 specificity to predict patellar instability (OR, 55.2; 95% CI, 20.5-148.6; p < 0.001).

CONCLUSION:

Among the evaluated risk factors, TT torsion had the highest predictive value for patellofemoral instability. Patients with TT torsions ≥ 17.7° showed a 55-fold increased probability of patellofemoral instability. Therefore, TT torsion should be included in the assessment of patients with patellofemoral instability. LEVEL OF EVIDENCE Level III.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tíbia / Tomografia Computadorizada por Raios X / Articulação Patelofemoral / Instabilidade Articular Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Assunto da revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tíbia / Tomografia Computadorizada por Raios X / Articulação Patelofemoral / Instabilidade Articular Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Assunto da revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Suíça