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Objective patellar instability: MR-based quantitative assessment of potentially associated anatomical features

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

To evaluate and compare the diagnostic utility of multiple quantitative parameters as measured on knee magnetic resonance (MR) examinations of patients suffering objective patellar instability (OPI). We performed a retrospective evaluation of knee MR examinations in a group of 46 patients (59 knees) with clinically proven OPI, and in a control group of 69 patients (71 knees). Multiple quantitative parameters in both groups were statistically evaluated and compared for their association with OPI. OPI patients tend to present shallower trochlear groove (<5 mm), larger Insall-Salvati index (>1.2), shorter patellar nose (<9 mm), smaller morphology ratio (<1.2), and larger patellar tilt (>11°) than control patients. The best sensitivities were those of the lateral patellar tilt (92.7%), the trochlear groove depth at the roman arch level (85.7%) and the Insall-Salvati index (78%). The best specificities were those of the morphology ratio (86.9%), the patellar nose (84.5%) and the patellar tendon length (84.5%). Shallow trochlear groove may be confidently identified at the roman arch view in OPI patients. Patella alta may be more reliably detected by the Insall-Salvati index in OPI patients. Patellar nose and morphology ratio are very specific indicators of OPI. A short patellar nose (that is to say, a patellar nose ratio of <0.25) has a high association with OPI. Lateral patellar tilt remains the single feature with the highest sensitivity and specificity for identifying OPI patients.

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Acknowledgements

We wish to express our gratitude to C. Lapra and T. Tavernier for providing us with the MR imaging studies of the OPI patients. We also wish to express our gratitude to J. Bates and the Language Service of the Rovira i Virgili University for their assistance in preparing the manuscript. The authors’ contributed to this study as follows: guarantors of integrity of the entire study: JSE, JMM, JG, PN; study concepts and design: JSE, JG, PN; definition of intellectual content: JSE, JG, PN; literature research: JSE, JMM; clinical studies: PN; data acquisition: JSE; data analysis: JSE, JMM, MO; statistical analysis: MO; manuscript preparation and editing: JSE, JMM; and manuscript review: JSE, JMM, JG, PN, AS.

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Authors and Affiliations

  1. Servei de Cirurgia Ortopèdica i Traumatologia, Hospital Universitari de Tarragona Joan XXIII, Carrer Doctor Mallafrè Guasch, 4, 43007, Tarragona, Spain

    Joan S. Escala & Josep Giné

  2. Institut de Diagnòstic per la Imatge, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain

    José M. Mellado & Amadeu Saurí

  3. Servei de Medicina Preventiva, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain

    Montserrat Olona

  4. Universitat Rovira i Virgili, Tarragona, Spain

    Montserrat Olona & Josep Giné

  5. Service de Chirurgie Ortopédique, Hôpital de la Croix-Rousse, Centre Livet, Caluire, France

    Phillipe Neyret

Authors
  1. Joan S. Escala
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  2. José M. Mellado
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  3. Montserrat Olona
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  4. Josep Giné
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  5. Amadeu Saurí
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  6. Phillipe Neyret
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Corresponding author

Correspondence to Joan S. Escala.

Additional information

The investigation was performed at: Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain, and Hôpital de la Croix-Rousse, Centre Livet, Caluire, France

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Escala, J.S., Mellado, J.M., Olona, M. et al. Objective patellar instability: MR-based quantitative assessment of potentially associated anatomical features. Knee Surg Sports Traumatol Arthrosc 14, 264–272 (2006). https://doi.org/10.1007/s00167-005-0668-z

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  • DOI: https://doi.org/10.1007/s00167-005-0668-z

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