Patellar shift ratio (PSR) is the optimal measurement for characterising lateral patellar shift and a reliable predictor of recurrent patellar dislocation

Chen, Jiebo; Ye, Zipeng; Wu, Chenliang; Zhang, Xueying; Zhao, Jinzhong; Xie, Guoming

doi:10.1007/s00167-022-07240-8

Cited by 3 publications

(2 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results from the normal group were compared with those from the case group to identify the optimal indicators for RPD across different age ranges within these protocols. Measurements (accuracy per pixel: 0.1 mm and 0.1°) [5,6,18,22] were subsequently conducted using standardised protocols, which are detailed below.…”

Section: Methodsmentioning

confidence: 99%

Impact of sex and age on the lateralisation of the tibial tubercle in normal paediatric and adolescent populations

Chen,

Sha,

Zhang

et al. 2024

Knee surg. sports traumatol. arthrosc.

Self Cite

View full text Add to dashboard Cite

PurposeNumerous methods have been proposed to characterise tubercle lateralisation. However, their normal values and related changes remain unclear. Accordingly, it was aimed to determine the potential sex and age effects and determined the optimal individualised method of diagnosing lateralisation of the tibial tubercle in patients with recurrent patellar dislocation (RPD).MethodsMeasurements included the tibial tubercle–trochlear groove (TT‐TG) distance, tibial tubercle‐posterior cruciate ligament (TT‐PCL) distance and tibial tubercle lateralisation (TTL); and the proximal tibial width (PTW), trochlear width (TW) and trochlear dysplasia index (TDI), for adjustment. A two‐way analysis of variance was used to determine the effect of age, sex and their interaction within the normal group. When the age effect was statistically significant, a nonlinear regression was created. Areas under the receiver‐operating characteristic curve (AUCs) were calculated to assess diagnostic accuracy.ResultsA total of 277 normal participants (mean [SD] age, 13.5 [2.6] years; 125 [45.1%] female) and 227 patients with RPD (mean [SD] age, 13.5 [2.6] years; 161 [58.1%] female) were analysed. It was found that in the normal group, in patients aged 7–10, TT‐PCL distance (p = 0.006), TTL (p = 0.007) and TT‐PCL/PTW (p < 0.001) were significantly larger in females than in males. A significant sex effect was also detected on TT‐TG/TW (p = 0.014). TT‐TG distance, TT‐PCL distance, TTL and TT‐PCL/PTW (in male patients) approached an established normal adult value of 12.3 mm, 20.9 mm, 0.64 and 0.28, respectively, with increasing age (p < 0.001). The AUC was greater for TT‐TG/TDI and TT‐TG/TW (p ≤ 0.01) and TT‐TG/TDI outperformed TT‐TG/TW in patients aged 15–18 (p = 0.004).ConclusionsTubercle lateralisation increased with age and was affected by sex, with the exception of TT‐TG distance and TT‐TG/TDI. TT‐TG/TDI is the optimal method of diagnosing a lateralized tibial tubercle in patients with RPD. These findings assist with the evaluation of tubercle lateralisation in that they provide a proper protocol for paediatric and adolescent populations with RPD; and thus, will help determine whether medial tubercle transfer should be included among the tailored surgical procedures considered for the treatment of patients with RPD.Level of EvidenceLevel III.

show abstract

Section: Methodsmentioning

confidence: 99%

Impact of sex and age on the lateralisation of the tibial tubercle in normal paediatric and adolescent populations

Chen,

Sha,

Zhang

et al. 2024

Knee surg. sports traumatol. arthrosc.

Self Cite

View full text Add to dashboard Cite

show abstract

“…The Wiberg index was quantified as the portion of the patellar width lateral to the apex of the patellar ridge. 8,10 Patellofemoral alignment included patellar tilt and bisect offset index. 3,41 Patellar tilt was quantified as the angle between the mediolateral axis and posterior condylar axis.…”

Section: Methodsmentioning

confidence: 99%

Patellar Dislocation in Adolescent Patients: Influence on Cartilage Properties Based on T1ρ Relaxation Times

Farrow,

Elias,

et al. 2023

Am J Sports Med

View full text Add to dashboard Cite

Background: Adolescents who experience a patellar dislocation have an elevated risk of patellofemoral posttraumatic osteoarthritis. Magnetic resonance imaging (MRI)–based T1ρ relaxation times were measured for adolescents to evaluate patellofemoral cartilage after patellar dislocation. Long T1ρ relaxation times are an indicator of cartilage degradation. Hypothesis: The primary hypothesis is that patellofemoral cartilage T1ρ relaxation times will be elevated in the acute phase after patellar dislocation. The secondary hypothesis is that T1ρ relaxation times will be higher for knees with multiple rather than single dislocations due to repeated traumatic injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: In total, 23 adolescents being treated for a recent patellar dislocation, 13 for a first-time dislocation (47 ± 38 days since most recent dislocation) and 10 for multiple dislocations (55 ± 24 days since most recent dislocation), and 10 healthy controls participated in MRI-based T1ρ relaxation time mapping. For multiple regions of the patellofemoral joint, mean T1ρ values were compared between the 3 groups with multiple group comparisons and post hoc tests. T1ρ relaxation times were also correlated against measures of patellofemoral anatomy and alignment for single and multiple dislocations. Statistical significance was set at P < .05. Results: T1ρ relaxation times were significantly longer for injured knees (single and multiple dislocations) than controls at the medial and central patella and central trochlear groove. For the regions on the patella, significant differences between injured and control knees exceeded 15%. No significant differences were identified between single and multiple dislocations. For the initial dislocation group, T1ρ relaxation times within multiple regions of the patellofemoral joint were significantly correlated with lateral patellar alignment or patellar height. Conclusion: Elevated patellofemoral cartilage T1ρ relaxation times are consistent with a high risk of long-term patellofemoral osteoarthritis for adolescents who experience patellar dislocations. T1ρ relaxation times were elevated for multiple regions of patellofemoral cartilage. T1ρ relaxation times were expected to increase with additional dislocation episodes, but relaxation times after single and multiple dislocations were similar. After a first dislocation, parameters related to patellar maltracking were correlated with cartilage degradation.

show abstract

Factors associated with an increased risk of osteochondral injuries after patellar dislocations: a systematic review

Yi,

Zhang,

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

Purpose The purpose of the study was to summarize the available evidence and identify risk factors for osteochondral injuries (OCIs) after patellar dislocations. Methods A systematic literature review was conducted in PubMed, Embase, Web of Science, Cochrane Library, and China national knowledge infrastructure from inception to December 22, 2022, according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Studies regarding risk factors for OCIs after patellar dislocations were included. Literature search, data extraction, and quality assessment were performed independently by two authors. Results A total of 16 studies with 1945 patients were included. The risk factors for OCIs after patellar dislocation were categorized into four main categories, including demographic characteristics, patellar depth and position, femoral trochlear morphology, and other risk factors in this study. Five and three studies supported the idea that male sex and skeletal maturation may be risk factors, respectively. Normal femoral trochlea (two studies) and complete medial patellofemoral ligament (MPFL) injuries (two studies) may be associated with the development of OCIs. Three studies show that ligamentous laxity or joint hypermobility may prevent OCIs. Patellar depth and position (eight studies) may not be associated with the development of OCIs. Conclusions Based on the available evidence, an increased risk of OCIs following patellar dislocation may be associated with male sex and skeletal maturation. Furthermore, normal femoral trochlea and complete MPFL injuries may increase the risk of OCIs, while factors such as ligamentous laxity or joint hypermobility may reduce the risk. Level of Evidence Level IV, systematic review of Level II and IV studies.

show abstract

Patellar shift ratio (PSR) is the optimal measurement for characterising lateral patellar shift and a reliable predictor of recurrent patellar dislocation

Cited by 3 publications

References 37 publications

Impact of sex and age on the lateralisation of the tibial tubercle in normal paediatric and adolescent populations

Impact of sex and age on the lateralisation of the tibial tubercle in normal paediatric and adolescent populations

Patellar Dislocation in Adolescent Patients: Influence on Cartilage Properties Based on T1ρ Relaxation Times

Factors associated with an increased risk of osteochondral injuries after patellar dislocations: a systematic review

Contact Info

Product

Resources

About