Comparison between conventional MRI and weight-bearing positional MRI reveals important differences in radiological measurements of the patellofemoral joint

Hansen, Philip; Harving, Mette Lønstrup; Øhlenschlæger, Tommy Frisgaard; Brinch, Signe; Lavard, Peter; Krogsgaard, Michael; Boesen, Mikael

doi:10.1007/s00256-023-04304-9

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…The change of the anterior PF joint alignment in the weight-bearing position can visually re ect the medial and lateral PF joint gap widths, PTA, PI, and PS. This weight-bearing state is closer to the physiological state and avoids the problems of simulation as well as the problems of being only partially weight-bearing or having a small knee exion angle when doing exion MRI [9].…”

Section: Introductionmentioning

confidence: 97%

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Influence of dynamic factors in weight-bearing position on the pathogenesis of medial patellofemoral joint cartilage injuries - a radiological in vivo study

Li,

Kang,

Han

et al. 2024

Preprint

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Objective This study aimed to prospectively compare the changes in the anterior patellofemoral(PF) alignment in the 30°, 60°, and 90° positions of knee flexion in non-weight-bearing and weight-bearing states to understand the pattern of PF joint motion and the causes of medial PF cartilage injury. Methods 22 young volunteers were recruited to participate in this study. PF axial radiographs of the right knee were taken in the prone and standing positions at 30°, 60°, and 90° of knee flexion, and the patellar tilt angle(PTA), Congruence Angle(CA), medial and lateral PF joint space width, patellofemoral index(PI), and patellar shift(PS) were measured. Statistical methods used were paired t-tests, One-Way ANOVA, and chi-square tests were used to prospectively compare the changes in PF joint alignment parameters between the non-weight-bearing and weight-bearing states in the prone and standing positions. Results There was a significant difference in the anterior alignment of the PF joint between the weight-bearing and non-weight-bearing positions at 30°, 60°, and 90° of knee flexion. The PTA was significantly smaller in the weight-bearing position than in the non-weight-bearing position, and the larger the knee flexion angle, the smaller the PTA. The patella was significantly displaced medially at 30°, 60°, and 90° of knee flexion in the weight-bearing position compared with the non-weight-bearing position. The PI was smaller in the weight-bearing than in the non-weight-bearing position at 60° and 90° of knee flexion, and the difference was statistically significant. In the same knee joint with 30°, 60°, and 90° of knee flexion, the number of knees with PI less than 1 with < 2 positions of knee flexion(30°, 60°, and 90° ) was 15 (68.2%) in the non-weight-bearing position compared with 5 (22.7%) in the weight-bearing position, and the number of knees with PI less than 1 with ≥ 2 positions of knee flexion(30°, 60°, and 90° ) was 7 (31.8%) in the non-weight-bearing position compared with 17 (77.3%) in the weight-bearing position; the difference was statistically significant. Conclusion The alignment pattern of the PF joint during dynamic activity in the weight-bearing position reflects the possibility that the medial PF compartment has hyperpressure and is responsible for the high incidence of medial PF cartilage injuries and the development of osteoarthritis(OA) of the medial PF compartment.

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Section: Introductionmentioning

confidence: 97%

“…Signi cant differences in the PF alignment and even PF motion between weight-bearing and non-weightbearing positions [7][8][9]. PF kinematics measured in supine, non-weight-bearing position do not accurately re ect joint motion during weight-bearing activities [10].…”

Section: Introductionmentioning

confidence: 99%

Influence of dynamic factors in weight-bearing position on the pathogenesis of medial patellofemoral joint cartilage injuries - a radiological in vivo study

Li,

Kang,

Han

et al. 2024

Preprint

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“…With tibiofemoral rotation being a risk factor for elevated TT‐TG, the addition of a TTO to surgical correction in PFI has traditionally been considered when the TT‐TG distance is greater than 20 mm [10, 11]. Further, a study by Hansen et al reported the need to standardise knee positioning during radiographic imaging as differences were found between supine and standing MRI scanning positions [12]. Recent studies have demonstrated that TT‐TG differs based off knee flexion [13, 14].…”

Section: Introductionmentioning

confidence: 99%

Measurement of TT‐TG can change with sequential MRIs due to variations in tibiofemoral rotation in patellofemoral instability patients

Pascual‐Leone,

Chipman,

Davie

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThere are various anatomic risk factors for patellofemoral instability (PFI) that help guide surgical treatment, including the tibial tubercle to trochlear groove (TT‐TG) distance. However, no study has analysed the temporal changes in TT‐TG prior to surgical intervention. This study sought to understand the variations in TT‐TG over time for pediatric patients suffering from PFI prior to surgical intervention. The authors hypothesised that the TT‐TG would substantially change between time points.MethodsPatients undergoing medial patellofemoral ligament (MPFL) reconstruction between 2014 and 2019 by one of two fellowship‐trained orthopaedic surgeons were identified. Patients were included if they had two preoperative magnetic resonance imaging (MRI) performed on the same knee within 7.5 months of each other prior to any surgical intervention and had an initial TT‐TG greater than 10 mm.ResultsAfter considering 251 patients for inclusion, 21 patients met the final inclusion criteria. The mean age was 14.5 ± 2.5 years and 61.9% were female. TT‐TG was initially noted to be 15.1 ± 1.8 mm. At mean time after sequential MRIs of 5.0 ± 1.9 months, TT‐TG was noted to be 16.7 ± 3.2 mm. The differences between initial and subsequent TT‐TG ranged from a 21.2% decrease to a 61.1% increase, with a mean difference of an 11.3% increase. Comparison between initial and subsequent TT‐TG values demonstrated a significant difference (p = 0.017). Change in tibiofemoral rotation ranged from −9.2° to 7.5°. When comparing the change in TT‐TG to change in tibiofemoral rotation, a significant correlation was found (p = 0.019).ConclusionDespite only a mean time between MRIs of 5 months, variations in TT‐TG ranged from a decrease of 21.2% to an increase of 61.1%. The significant relationship between the changes in TT‐TG and changes in tibiofemoral rotation between MRIs suggest that TT‐TG measurements may vary due to variations in tibiofemoral rotation at the time of individual MRIs.Level of Evidence: Level IV.

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Comparison between conventional MRI and weight-bearing positional MRI reveals important differences in radiological measurements of the patellofemoral joint

Cited by 2 publications

References 30 publications

Influence of dynamic factors in weight-bearing position on the pathogenesis of medial patellofemoral joint cartilage injuries - a radiological in vivo study

Influence of dynamic factors in weight-bearing position on the pathogenesis of medial patellofemoral joint cartilage injuries - a radiological in vivo study

Measurement of TT‐TG can change with sequential MRIs due to variations in tibiofemoral rotation in patellofemoral instability patients

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