Cargando…
The Tibial Tuberosity–Rotational Angle as a Novel Predisposing Parameter for Patellar Dislocation
BACKGROUND: The tibial tuberosity (TT) in the axial plane is located on a curved line along the anterior cortex of the proximal tibia. Therefore, the linear measurement of TT position may not fully reflect TT malposition. PURPOSE: To introduce TT–rotational angle (TT-RA) as a new anatomical paramete...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793030/ https://www.ncbi.nlm.nih.gov/pubmed/36582930 http://dx.doi.org/10.1177/23259671221142626 |
_version_ | 1784859766415163392 |
---|---|
author | Kim, Tae Jin Lee, Tae Jin Song, Hyun-Sub Bae, Ji Hoon |
author_facet | Kim, Tae Jin Lee, Tae Jin Song, Hyun-Sub Bae, Ji Hoon |
author_sort | Kim, Tae Jin |
collection | PubMed |
description | BACKGROUND: The tibial tuberosity (TT) in the axial plane is located on a curved line along the anterior cortex of the proximal tibia. Therefore, the linear measurement of TT position may not fully reflect TT malposition. PURPOSE: To introduce TT–rotational angle (TT-RA) as a new anatomical parameter, which means the rotation of the TT relative to the dorsal condylar line of the tibia, and to validate its predictive value for patellar dislocation. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Included were 46 patients with a history of patellar dislocation and 46 age- and sex-matched controls who underwent axial magnetic resonance imaging. Seven radiological parameters were measured and compared between the 2 groups, including TT–trochlear groove (TT-TG) distance, tibial tubercle–posterior cruciate ligament (TT-PCL) distance, TT-PCL ratio, TT lateralization (TTL), trochlear groove medialization (TGM), TT-RA, trochlear groove–posterior condylar axis angle (TG-PCA), and knee rotation. The predictive values of parameters for patellar dislocation were assessed using multiple logistic regression analysis. RESULTS: The intra- and interobserver correlation coefficients for measuring the radiographic parameters showed good to excellent values., respectively. There were significant differences in the TT-TG distance (13.9 vs 6.8 mm; P < .001), TT-RA (16.0° vs 9.1°; P < .001), TG-PCA (93.7° vs 95.4°; P = .017), and knee rotation (0.9° vs 5.3°; P < .001) between the 2 groups. However, there was no significant difference in TT-PCL distance (20.7 vs 19.4 mm; P = .075), TT-PCL ratio (28.0% vs 26.6%; P = .136), TTL (65.7% vs 64.9%; P = .270), or TGM (54.9% vs 55.0%; P = .923). Multivariable analysis showed that 3 parameters were significantly associated with patellar dislocation: TT-RA (OR, 1.57; P < .001), TT-TG distance (OR, 1.52; P = .002), and knee rotation (OR, 0.75; P = .022). CONCLUSION: The TT-RA was a reliable predisposing parameter of patellar instability. It can be an alternative method of measurement when the TT-TG distance is not clearly defined. |
format | Online Article Text |
id | pubmed-9793030 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-97930302022-12-28 The Tibial Tuberosity–Rotational Angle as a Novel Predisposing Parameter for Patellar Dislocation Kim, Tae Jin Lee, Tae Jin Song, Hyun-Sub Bae, Ji Hoon Orthop J Sports Med Article BACKGROUND: The tibial tuberosity (TT) in the axial plane is located on a curved line along the anterior cortex of the proximal tibia. Therefore, the linear measurement of TT position may not fully reflect TT malposition. PURPOSE: To introduce TT–rotational angle (TT-RA) as a new anatomical parameter, which means the rotation of the TT relative to the dorsal condylar line of the tibia, and to validate its predictive value for patellar dislocation. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Included were 46 patients with a history of patellar dislocation and 46 age- and sex-matched controls who underwent axial magnetic resonance imaging. Seven radiological parameters were measured and compared between the 2 groups, including TT–trochlear groove (TT-TG) distance, tibial tubercle–posterior cruciate ligament (TT-PCL) distance, TT-PCL ratio, TT lateralization (TTL), trochlear groove medialization (TGM), TT-RA, trochlear groove–posterior condylar axis angle (TG-PCA), and knee rotation. The predictive values of parameters for patellar dislocation were assessed using multiple logistic regression analysis. RESULTS: The intra- and interobserver correlation coefficients for measuring the radiographic parameters showed good to excellent values., respectively. There were significant differences in the TT-TG distance (13.9 vs 6.8 mm; P < .001), TT-RA (16.0° vs 9.1°; P < .001), TG-PCA (93.7° vs 95.4°; P = .017), and knee rotation (0.9° vs 5.3°; P < .001) between the 2 groups. However, there was no significant difference in TT-PCL distance (20.7 vs 19.4 mm; P = .075), TT-PCL ratio (28.0% vs 26.6%; P = .136), TTL (65.7% vs 64.9%; P = .270), or TGM (54.9% vs 55.0%; P = .923). Multivariable analysis showed that 3 parameters were significantly associated with patellar dislocation: TT-RA (OR, 1.57; P < .001), TT-TG distance (OR, 1.52; P = .002), and knee rotation (OR, 0.75; P = .022). CONCLUSION: The TT-RA was a reliable predisposing parameter of patellar instability. It can be an alternative method of measurement when the TT-TG distance is not clearly defined. SAGE Publications 2022-12-22 /pmc/articles/PMC9793030/ /pubmed/36582930 http://dx.doi.org/10.1177/23259671221142626 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Kim, Tae Jin Lee, Tae Jin Song, Hyun-Sub Bae, Ji Hoon The Tibial Tuberosity–Rotational Angle as a Novel Predisposing Parameter for Patellar Dislocation |
title | The Tibial Tuberosity–Rotational Angle as a Novel Predisposing
Parameter for Patellar Dislocation |
title_full | The Tibial Tuberosity–Rotational Angle as a Novel Predisposing
Parameter for Patellar Dislocation |
title_fullStr | The Tibial Tuberosity–Rotational Angle as a Novel Predisposing
Parameter for Patellar Dislocation |
title_full_unstemmed | The Tibial Tuberosity–Rotational Angle as a Novel Predisposing
Parameter for Patellar Dislocation |
title_short | The Tibial Tuberosity–Rotational Angle as a Novel Predisposing
Parameter for Patellar Dislocation |
title_sort | tibial tuberosity–rotational angle as a novel predisposing
parameter for patellar dislocation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793030/ https://www.ncbi.nlm.nih.gov/pubmed/36582930 http://dx.doi.org/10.1177/23259671221142626 |
work_keys_str_mv | AT kimtaejin thetibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation AT leetaejin thetibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation AT songhyunsub thetibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation AT baejihoon thetibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation AT kimtaejin tibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation AT leetaejin tibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation AT songhyunsub tibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation AT baejihoon tibialtuberosityrotationalangleasanovelpredisposingparameterforpatellardislocation |