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Year :2017
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Month :
July-August
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Volume :
6
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Issue :
3
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Page :
RO52 - RO56
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Role of MRI in Assessment of Risk Factors for Patello Femoral Instability
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Correspondence Address :
VEDARAJU K S, RAMALINGAIAH K H, NIKITA K JAIN,
Dr. Nikita K Jain
Ashirwad” No 4-5 West Link Road,
3rd Cross Malleshwaram,
Bengaluru-560003, Karnataka, India.
E-mail: niki_jain99@yahoo.co.in
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Introduction: Introduction: Patellar pathologies are a common cause for anterior knee pain. The Patello-Femoral Joint (PFJ) is a highly complex joint with high biomechanical and functional requirements. Joint geometry plays an important role for stabilization during movements. Developmental and acquired alterations in the geometry of the PFJ are associated with various patellar pathologies.
Aim: To study the diagnostic accuracy of MRI evaluation parameters for trochlear dysplasia in cases of patellar instability. Also, to assess the patellar height ratio using Insail-Salvati index in cases of patellar instability and to assess the Tibial Tubercle to Trochlear Groove distance (TTTG) in cases of patellar instability.
Materials and Methods: MRI Knee scan of 20 study cases of patello- femoral instability and 20 control cases were studied prospectively between December 2015 to 2016. MRI knee was performed using 1.5 T Seimens AVANTO system. The following measurements and criteria were used for evaluation of trochlear dysplasia- 1. Dejour’s classification of morphological types of trochlear dysplasia: 2. Lateral trochlear inclination angle. 3. Trochlear facet asymmetry ratio 4. Trochlear depth. Patella Alta was assessed using InsalL-Salvati index and TTTG distance was calculated on axial section Images.
Results: The mean age group was ~29 years and median age group was 27 years. Morphology of trochlear dysplasia in study group: Type A -10 cases (50%); Type B- 1 case; Type C- 9 cases (45%); Type D- Nil. The mean lateral inclination angle showed 95% sensitivity and 100% specificity for trochlear dysplasia. The mean trochlear facet ratio showed 75% sensitivity and 100% specificity. The mean trochlear depth showed 90% sensitivity and 100% specificity. Patella alta was seen in 18 out of 20 study cases.The mean tibial tuberosity to trochlear distance was ~19.28mm in study group and ~ 7.2mm in control group.
Conclusion: MRI plays an important role in assessment of risk factors for patello-femoral instability. Standardized MR parameters helps in accurate diagnosis of trochlear dysplasia, lateralization of tibial tuberosity and patella alta and helps in optimal treatment planning.
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