Avaliação dos métodos de mensuração da altura patelar na radiografia digital

Gracitelli, Guilherme Conforto; Pierami, Rafael; Tonelli, Thomaz Antônio; Falótico, Guilherme Guadagnini; Silva, Flávio Duarte; Nakama, Gilberto Yoshinobu; Franciozi, Carlos Eduardo da Silveira; Queiroz, Antônio Altenor Bessa de; Filho, Mário Carneiro

doi:10.1590/s0102-36162012000200011

Cited by 19 publications

(4 citation statements)

References 24 publications

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“…Our investigation was conducted using digital radiographs, on the basis of the study by Gracitelli et al 1 According to these authors, use of digital radiographs is becoming ever more widely disseminated. Moreover, the advantages of this radiography system in relation to the conventional technique are its speed and precision, the elimination of printing and its associated costs and the ease of image display.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the advantages of this radiography system in relation to the conventional technique are its speed and precision, the elimination of printing and its associated costs and the ease of image display. 1 In our opinion, the most important point that these authors cited is that the x-ray doses required for digital radiography are lower: the dose is adjusted so that the image has an appropriate signal-to-noise ratio and the radiation absorbed by the patient is diminished. 1 Our thinking is that with digital images, the measurements of the anatomical points through the software become more precise.…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted in Brazil by Gracitelli et al, 1 in which patellar height measurements were compared, it was observed that the observer's experience had an influence in analyses on the reproducibility of the measurements. Thus, we used an observed with great experience in using these patellar indexes and also we did not stipulate a response time, in order to attempt to reproduce the evaluations with greater precision.…”

Section: Discussionmentioning

confidence: 99%

“…Patellar height measurement is increasingly being used as knowledge of knee biomechanics and the physiopathology of knee diseases and their respective treatments expands. 1 …”

Section: Introductionmentioning

confidence: 99%

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Comparative evaluation of patellar height methods in the Brazilian population

Behrendt

Zaluski

Albuquerque

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveThe methods most used for patellar height measurement were compared with the plateau–patella angle method.MethodsA cross-sectional study was conducted, in which lateral-view radiographs of the knee were evaluated using the three methods already established in the literature: Insall–Salvati (IS), Blackburne–Peel (BP) and Caton–Deschamps (CD). These were compared with the plateau–patella angle method. One hundred and ninety-six randomly selected patients were included in the sample.ResultsThe data were initially evaluated using the chi-square test. This analysis was deemed to be positive with p < 0.0001. We compared the traditional methods with the plateau–patella angle measurement, using Fisher's exact test. In comparing the IS index with the plateau–patella angle, we did not find any statistically significant differences in relation to the proportion of altered cases between the two groups. The traditional methods were compared with the plateau–patella angle with regard to the proportions of cases of high and low patella, by means of Fisher's exact test. This analysis showed that the plateau–patella angle identified fewer cases of high patella than did the IS, BP and CD methods, but more cases of low patella. In comparing pairs, we found that the IS and CD indices were capable of identifying more cases of high patella than was the plateau–patella angle. In relation to the cases of low patella, the plateau–patella angle was capable of identifying more cases than were the other three methods.ConclusionsThe plateau–patella angle found more patients with low patella than did the classical methods and showed results that diverged from those of the other indices studied.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Patellar height measurement is increasingly being used as knowledge of knee biomechanics and the physiopathology of knee diseases and their respective treatments expands. 1 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparative evaluation of patellar height methods in the Brazilian population

Behrendt

Zaluski

Albuquerque

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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Patellar height measurements: Insall–Salvati ratio is most reliable method

Verhulst

Sambeeck

Olthuis

et al. 2019

Knee Surg Sports Traumatol Arthrosc

120

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Purpose Patella alta is a risk factor for patellofemoral pain and instability. Several measurement methods and imaging modalities are in use to measure patellar height. The first aim of this study was to determine the intra-and interrater reliability of different patellar height measurement methods on conventional radiography (CR), CT and MRI. The second aim was to examine the applicability of patellar height measurement methods originally designed for CR on CT and MRI. Methods Forty-eight patients who were treated for patellar instability were included. All patients had undergone a pre-operative conventional radiograph, CT scan and MRI. Five methods for measuring patellar height were performed on radiographs, CT and MRI by four observers. For each measurement, the intra-and interrater reliability was determined by calculating the intra-class correlation coefficient (ICC). A Bland-Altman analysis was performed for measurements with an ICC ≥ 0.70. ResultsThe Insall-Salvati (IS) ratio was the only measurement that showed good intra-and inter-observer reliability on CR, CT and MRI. The intra-and inter-observer reliability of the patellotrochlear index (PTI) for MRI was good to excellent for all observers. The IS ratio showed a moderate to good reliability for comparison of all three imaging modalities with the best agreement between radiography and MRI. The other patellar height measurements showed only poor to moderate inter-method agreement. Conclusion In this study, the Insall-Salvati ratio shows better intra-and inter-observer reliability than the Blackburne-Peel ratio, the Caton-Deschamps ratio and the modified Insall-Salvati ratio on all imaging modalities. Radiography and CT seem to have better reliability than MRI. The patellotrochlear index, however, shows good inter-and intra-observer reliability on MRI. Only for the IS method was there acceptable agreement between CR and MRI. This means that the established Insall-Salvati normal values could be used for MRI as well. This study shows that the most reliable method to measure patella height is the Insall-Salvati ratio measured on conventional radiographs or the patellotrochlear index on MRI. Level of evidence Level II diagnostic.

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Reliability of a Caton-Deschamps-derived patella height index for knee arthroplasty

Konrads

Grosse

Ahmad

et al. 2021

International Orthopaedics (SICOT)

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Purpose The original Caton-Deschamps index (oCDI) detects functional patella height. It cannot be used in knees with an implanted endoprosthesis. The “modified Caton-Deschamps index” (mCDI) for knee arthroplasty can miss pseudo-patella-infera (PPI), which is common after TKA. A derivate of the oCDI could be a simple analogue to the index published in 1982 using a modified tibial reference point at the anterior proximal point of the inlay, which can indirectly be located on the lateral knee radiograph. It was the aim of this study to determine the intra- and inter-rater agreement of a derived Caton-Deschamps index (dCDI) for knee arthroplasty. We hypothesized that the derived Caton-Deschamps index (dCDI) is a reliable radiological measure for patella height in knee arthroplasty. Methods Several patella height indices were measured by three independent raters in two passes. The second pass was performed after 6 weeks in random order. Intra- and inter-observer agreements were determined and analyzed using the intraclass correlation coefficient (ICC). For radiographic evaluation, digital lateral radiographs of 150 knees before and after primary TKA were used. Results We found high interrater reliability for all analyzed indices. We found the highest agreements for the ISI preop (ICC = 0.914) and postop (ICC = 0.920), respectively. We also found very good intra-rater reliability for the CDI (ICCpreop = 0.954), dCDI (ICCpostop = 0.945), ISI (ICCpreop = 0.960; ICCpostop=0.940) and BPI (ICCpreop = 0.969; ICCpostop = 0.955). Fourteen cases (9.3%) with insignificant PPI were found. Conclusion The derived Caton-Deschamps index (dCDI) can easily be used in knee arthroplasty and demonstrated high intra- and interrater agreement, which was similar to other commonly used and established patella height indices.

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Avaliação dos métodos de mensuração da altura patelar na radiografia digital

Cited by 19 publications

References 24 publications

Comparative evaluation of patellar height methods in the Brazilian population

Comparative evaluation of patellar height methods in the Brazilian population

Patellar height measurements: Insall–Salvati ratio is most reliable method

Reliability of a Caton-Deschamps-derived patella height index for knee arthroplasty

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