Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati Ratio

Purpose. To assess the Insall-Salvati ratio in normal Indian adults to determine its applicability and the incidence of patella alta and baja in Indian populations. Method. 800 knees in 200 men and 200 women aged 18 to 50 (mean, 30) years were evaluated using lateral radiographs. The knee was set in...

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Main Authors: Sachin Upadhyay, HKT Raza, Pranay Srivastava
Format: Article
Language:English
Published: SAGE Publishing 2013-04-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/230949901302100108
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author Sachin Upadhyay
HKT Raza
Pranay Srivastava
author_facet Sachin Upadhyay
HKT Raza
Pranay Srivastava
author_sort Sachin Upadhyay
collection DOAJ
description Purpose. To assess the Insall-Salvati ratio in normal Indian adults to determine its applicability and the incidence of patella alta and baja in Indian populations. Method. 800 knees in 200 men and 200 women aged 18 to 50 (mean, 30) years were evaluated using lateral radiographs. The knee was set in semi-flexion (30°) to enable good visualisation of the patellar tendon and its insertion into the tibia on radiographs. The length of the patellar tendon (LT) over the length of the patella (LP)—the Insall-Salvati ratio—was measured, using a vernier caliper. Results. The mean LT/LP ratio was 1.14 (standard deviation, 0.18). Based on the 95% confidence interval, the ratio was considered normal if within ±40%. The LT/LP ratio was significantly higher in females than males (1.17 vs. 1.12, p<0.01). The cut-off point of patella alta was significantly greater in our Indian subjects than in western subjects (>1.5 vs. >1.2, p<0.0001). In the present cohort, the frequencies of patella alta (ratio, >1.5) and patella baja (ratio, <0.7) were 2.8% and 1%, respectively. Conclusion. The use of the Insall-Salvati ratio to determine the patellar position is less applicable to Indian populations in which squatting, sitting cross-legged, and kneeling are customs. We propose that the normal range of the ratio for squatters among Indian populations be 0.7 to 1.5.
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spelling doaj.art-3f7c885781bd4ddebf19e8ddb038f13b2022-12-21T20:35:41ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902013-04-012110.1177/230949901302100108Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati RatioSachin UpadhyayHKT RazaPranay SrivastavaPurpose. To assess the Insall-Salvati ratio in normal Indian adults to determine its applicability and the incidence of patella alta and baja in Indian populations. Method. 800 knees in 200 men and 200 women aged 18 to 50 (mean, 30) years were evaluated using lateral radiographs. The knee was set in semi-flexion (30°) to enable good visualisation of the patellar tendon and its insertion into the tibia on radiographs. The length of the patellar tendon (LT) over the length of the patella (LP)—the Insall-Salvati ratio—was measured, using a vernier caliper. Results. The mean LT/LP ratio was 1.14 (standard deviation, 0.18). Based on the 95% confidence interval, the ratio was considered normal if within ±40%. The LT/LP ratio was significantly higher in females than males (1.17 vs. 1.12, p<0.01). The cut-off point of patella alta was significantly greater in our Indian subjects than in western subjects (>1.5 vs. >1.2, p<0.0001). In the present cohort, the frequencies of patella alta (ratio, >1.5) and patella baja (ratio, <0.7) were 2.8% and 1%, respectively. Conclusion. The use of the Insall-Salvati ratio to determine the patellar position is less applicable to Indian populations in which squatting, sitting cross-legged, and kneeling are customs. We propose that the normal range of the ratio for squatters among Indian populations be 0.7 to 1.5.https://doi.org/10.1177/230949901302100108
spellingShingle Sachin Upadhyay
HKT Raza
Pranay Srivastava
Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati Ratio
Journal of Orthopaedic Surgery
title Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati Ratio
title_full Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati Ratio
title_fullStr Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati Ratio
title_full_unstemmed Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati Ratio
title_short Position of the Patella in Adults in Central India: Evaluation of the Insall-Salvati Ratio
title_sort position of the patella in adults in central india evaluation of the insall salvati ratio
url https://doi.org/10.1177/230949901302100108
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AT pranaysrivastava positionofthepatellainadultsincentralindiaevaluationoftheinsallsalvatiratio