Role of MRI in Assessment of Risk Factors for Patello Femoral Instability
Introduction: Patellar pathologies are a common cause for anterior knee pain. The Patello-Femoral Joint (PFJ) is a highly complex joint with high biomechanical and functional requirements. Joint geometry plays an important role for stabilization during movements. Developmental and acquired alte...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2017-07-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/articles/PDF/2294/28314_CE(VSU)_F(AK)_PF1(VSUAK)_PFA(GG)_PF2(VSU_GG).pdf |
| Summary: | Introduction: Patellar pathologies are a common cause
for anterior knee pain. The Patello-Femoral Joint (PFJ)
is a highly complex joint with high biomechanical and
functional requirements. Joint geometry plays an important
role for stabilization during movements. Developmental
and acquired alterations in the geometry of the PFJ are
associated with various patellar pathologies.
Aim: To study the diagnostic accuracy of MRI evaluation
parameters for trochlear dysplasia in cases of patellar
instability. Also, to assess the patellar height ratio using
Insail-Salvati index in cases of patellar instability and to
assess the Tibial Tubercle to Trochlear Groove distance
(TTTG) in cases of patellar instability.
Materials and Methods: MRI Knee scan of 20 study cases
of patello- femoral instability and 20 control cases were
studied prospectively between December 2015 to 2016.
MRI knee was performed using 1.5 T Seimens AVANTO
system. The following measurements and criteria were used
for evaluation of trochlear dysplasia1. Dejour’s classification of morphological types of trochlear
dysplasia:
2. Lateral trochlear inclination angle.
3. Trochlear facet asymmetry ratio
4. Trochlear depth.
Patella Alta was assessed using InsalL-Salvati index and
TTTG distance was calculated on axial section Images.
Results: The mean age group was ~29 years and median
age group was 27 years.
Morphology of trochlear dysplasia in study group: Type A
-10 cases (50%); Type B- 1 case; Type C- 9 cases (45%);
Type D- Nil. The mean lateral inclination angle showed 95%
sensitivity and 100% specificity for trochlear dysplasia.
The mean trochlear facet ratio showed 75% sensitivity and
100% specificity. The mean trochlear depth showed 90%
sensitivity and 100% specificity.
Patella alta was seen in 18 out of 20 study cases.The mean
tibial tuberosity to trochlear distance was ~19.28mm in
study group and ~ 7.2mm in control group.
Conclusion: MRI plays an important role in assessment
of risk factors for patello-femoral instability. Standardized
MR parameters helps in accurate diagnosis of trochlear
dysplasia, lateralization of tibial tuberosity and patella alta
and helps in optimal treatment planning. |
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| ISSN: | 2277-8543 2455-6874 |