The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangements
Abstract Background To investigate differences in the tibial tubercle-trochlear groove (TT-TG) and patellar tendon-posterior cruciate ligament (PT-PCL) distances in symptomatic patients with non-contact internal knee derangements (IKD) and symptomatic patients with internally intact knees (control)....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01661-2 |
| _version_ | 1798038988224724992 |
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| author | Kyle S. Stumetz M. D. Gothard Ronald F. Walser Alan G. Greenwald Wade W. Justice |
| author_facet | Kyle S. Stumetz M. D. Gothard Ronald F. Walser Alan G. Greenwald Wade W. Justice |
| author_sort | Kyle S. Stumetz |
| collection | DOAJ |
| description | Abstract Background To investigate differences in the tibial tubercle-trochlear groove (TT-TG) and patellar tendon-posterior cruciate ligament (PT-PCL) distances in symptomatic patients with non-contact internal knee derangements (IKD) and symptomatic patients with internally intact knees (control). Methods A retrospective review of MRI studies was completed by comparing 78 patients with meniscal and ligamentous derangements of the knee to 63 internally intact knees (age range, 13 to 50 years). MRI findings were reviewed independently by two board-certified radiologists to assess for agreement. TT-TG and PT-PCL distances were measured on proton density-weighted axial images by two independent observers blinded to the MRI and arthroscopic findings. Independent t tests were used to determine differences in TT-TG distance between the internal derangement and control groups. Chi-square tests were used to compare categorical variables for distributional equality between study groups. Results The mean TT-TG distance averaged across the two raters in the IKD group was 11.5 mm (95% confidence interval [CI], 10.6–12.4), compared to 8.3 mm (95% CI, 7.6–9.0) in the control group (p < 0.001). The mean PT-PCL distance similarly averaged across both raters was 20.6 mm (95% CI, 19.7–21.5) for the IKD group compared to 18.2 mm (95% CI, 17.2–19.2) for the control group (p < 0.001). Among the IKD group, there were 51 meniscal tears, 12 cruciate ligament tears, and 15 tears with a combination of meniscal and cruciate findings. IKD was significantly correlated with greater TT-TG distance (p < 0.001) and greater PT-PCL distance (p < 0.003) when compared with control. Conclusions Increased TT-TG distances and PT-PCL distances are associated with both cartilaginous and ligamentous internal knee injuries in the present study, with TT-TG distances greater than the 12 mm representing a new threshold for concern. |
| first_indexed | 2024-04-11T21:47:44Z |
| format | Article |
| id | doaj.art-4c095576e8eb4720bc7973af94937af7 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T21:47:44Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-4c095576e8eb4720bc7973af94937af72022-12-22T04:01:22ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-04-011511810.1186/s13018-020-01661-2The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangementsKyle S. StumetzM. D. GothardRonald F. WalserAlan G. GreenwaldWade W. JusticeAbstract Background To investigate differences in the tibial tubercle-trochlear groove (TT-TG) and patellar tendon-posterior cruciate ligament (PT-PCL) distances in symptomatic patients with non-contact internal knee derangements (IKD) and symptomatic patients with internally intact knees (control). Methods A retrospective review of MRI studies was completed by comparing 78 patients with meniscal and ligamentous derangements of the knee to 63 internally intact knees (age range, 13 to 50 years). MRI findings were reviewed independently by two board-certified radiologists to assess for agreement. TT-TG and PT-PCL distances were measured on proton density-weighted axial images by two independent observers blinded to the MRI and arthroscopic findings. Independent t tests were used to determine differences in TT-TG distance between the internal derangement and control groups. Chi-square tests were used to compare categorical variables for distributional equality between study groups. Results The mean TT-TG distance averaged across the two raters in the IKD group was 11.5 mm (95% confidence interval [CI], 10.6–12.4), compared to 8.3 mm (95% CI, 7.6–9.0) in the control group (p < 0.001). The mean PT-PCL distance similarly averaged across both raters was 20.6 mm (95% CI, 19.7–21.5) for the IKD group compared to 18.2 mm (95% CI, 17.2–19.2) for the control group (p < 0.001). Among the IKD group, there were 51 meniscal tears, 12 cruciate ligament tears, and 15 tears with a combination of meniscal and cruciate findings. IKD was significantly correlated with greater TT-TG distance (p < 0.001) and greater PT-PCL distance (p < 0.003) when compared with control. Conclusions Increased TT-TG distances and PT-PCL distances are associated with both cartilaginous and ligamentous internal knee injuries in the present study, with TT-TG distances greater than the 12 mm representing a new threshold for concern.http://link.springer.com/article/10.1186/s13018-020-01661-2TT-TGPT-PCLPatellar instabilityPatellar lateralizationMeniscus tearsCruciate tears |
| spellingShingle | Kyle S. Stumetz M. D. Gothard Ronald F. Walser Alan G. Greenwald Wade W. Justice The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangements Journal of Orthopaedic Surgery and Research TT-TG PT-PCL Patellar instability Patellar lateralization Meniscus tears Cruciate tears |
| title | The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangements |
| title_full | The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangements |
| title_fullStr | The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangements |
| title_full_unstemmed | The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangements |
| title_short | The relationship between patellar lateralization diagnostic imaging markers and non-contact internal knee derangements |
| title_sort | relationship between patellar lateralization diagnostic imaging markers and non contact internal knee derangements |
| topic | TT-TG PT-PCL Patellar instability Patellar lateralization Meniscus tears Cruciate tears |
| url | http://link.springer.com/article/10.1186/s13018-020-01661-2 |
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