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Usefulness of three-dimensional computed tomography for patellofemoral measurement

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to establish the normal values for knee patellofemoral alignment as measured using 3-dimensional computed tomography (3D CT), to standardize the technique, and to show the inter- and intra-observer reliability of this measurement.

Methods

The present study included 62 asymptomatic volunteers (124 knees). 3D CT scanning was performed with each volunteer in the supine position with 15° of knee flexion, and consistent 3D axial images of the patellofemoral joint were obtained with alignment in the desired stereographic baseline direction in anterior–posterior, lateral, and axial rotations. Two independent observers measured patellofemoral alignment parameters, including the sulcus angle, congruence angle, lateral patellofemoral angle, condyle-patellar angle, and lateral trochlear inclination angle.

Results

Based on 3D CT measurement, the mean values of the parameters were 145.9° ± 9.2° for the sulcus angle, 12.6° ± 22.6° for the congruence angle, 9.2° ± 4.6° for the lateral patellofemoral angle, 14.1° ± 6.4° for the condyle-patellar (lateral facets) angle, − 8.5° ± 8.4° for condyle-patellar (patellar axis) angle, and 16.5° ± 6.3° for the lateral trochlear inclination angle. A statistically significant difference was observed between men and women in the sulcus and condyle-patellar (patellar axis) angles (p = 0.045, 0.011, respectively). All parameters showed excellent inter- and intra-observer reliability.

Conclusion

The normal values and ranges for patellofemoral alignment parameters were evaluated using 3D CT. The results of this study provide reference information that may facilitate diagnosis and treatment planning of patellofemoral disorders in skeletally mature non-pathologic patients.

Level of evidence

II

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Authors and Affiliations

  1. Department of Orthopedic Surgery, College of Medicine, Asan Foundation, Gangneung Asan Hospital, University of Ulsan, 38, Bangdong-gil, Sacheon-Myeon, Gangneung-si, Gangwon-do, 25440, South Korea

    Ki Won Lee, Dong-Kyo Seo, Joo-Yul Bae, Ho Jong Ra & Jin Kyung Kim

  2. Department of Radiology, College of Medicine, Asan Foundation, Gangneung Asan Hospital, University of Ulsan, 38, Bangdong-gil, Sacheon-Myeon, Gangneung-si, Gangwon-do, 25440, South Korea

    Soo-Jung Choi

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  1. Ki Won Lee
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Contributions

All authors contributed study design, data collecting, analysis, manuscript writing, and revision.

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Correspondence to Dong-Kyo Seo.

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The authors declare that they have no conflict of interest.

Ethical approval

This study (IRB number GNAH2017-12-002-0001) was approved by our institutional (Gangneung Asan Hospital) review board.

Informed consent

Voluntary informed consent was required. Plain radiographs of both knees and medical history of all volunteers were checked.

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Lee, K.W., Seo, DK., Bae, JY. et al. Usefulness of three-dimensional computed tomography for patellofemoral measurement. Knee Surg Sports Traumatol Arthrosc 30, 1423–1429 (2022). https://doi.org/10.1007/s00167-021-06624-6

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  • DOI: https://doi.org/10.1007/s00167-021-06624-6

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