Sagittal patellar flexion angle measurement determines greater incidence of patella alta in patellar tendinopathy patien
- PDF / 833,122 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 26 Downloads / 167 Views
KNEE
Sagittal patellar flexion angle measurement determines greater incidence of patella alta in patellar tendinopathy patients Kimberley Kai Lun1 · Stephen Bennie1 · James D. Crowley1 · Phil Lucas2 · Mervyn Cross3 · William R. Walsh1 · Michael J. Dan1 Received: 19 August 2020 / Accepted: 5 November 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose The objective of this study was to compare patellar height and patella alta between a control cohort and patients with patellar tendinopathy by the sagittal patellar flexion angle (SPFA) measurement. Methods Magnetic resonance imaging (MRI) scans of the knee were obtained from a sports imaging facility and screened to select patients with anterior knee pain. This symptomatic group was divided into two patient cohorts: those with and without MRI features of patellar tendinopathy. Lateral knee radiographs were reviewed and SPFA, knee flexion angle and Insall–Salvati ratio (IS) were measured from the radiographs by two independent reviewers. Results A total of 99 patients consisting of 48 patellar tendinopathy patients and 51 control patients were included. There was a significantly higher mean patellar height (p = 0.002, d = 0.639) and a greater patella alta incidence in the patellar tendinopathy cohort (25.0%) compared to the controls (3.9%) (p = 0.022, d = 0.312). Insall–Salvati ratio measurements showed no difference in patella alta incidence between tendinopathy and control cohorts. There was excellent inter- and intra-observer reliability of SPFA measurements (ICC 0.99). Conclusion This is the first study to demonstrate a greater incidence of patella alta in patellar tendinopathy patients compared to controls. A greater patella alta incidence amongst patellar tendinopathy patients as defined by SPFA was found to be clinically relevant, as it suggests these patients may comprise the recalcitrant patient subgroup who do not improve with current surgical intervention and may therefore benefit from a biomechanical surgical solution. Level of evidence III. Keywords Patella alta · Patellar height · Patellar tendinopathy · Sagittal kinematics
Introduction Patellar height is an important clinical factor in many patellofemoral conditions. Abnormal patellar height may disrupt the patellofemoral joint by disadvantaging the knee extensor mechanism, and is associated with multiple
patellofemoral pathologies including recurrent patellar dislocation, chondromalacia patella and patellofemoral pain [10, 23, 35]. Subsequently, patellar height measurement is a key assessment in evaluating knee pathologies, recognising patellar instability and formulating patient management strategies. Common patellar height measurements
* Michael J. Dan [email protected]
Mervyn Cross [email protected]
Kimberley Kai Lun [email protected]
William R. Walsh [email protected]
Stephen Bennie [email protected]
1
Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of Ne
Data Loading...
