Objective assessment of patellar maltracking with 3 T dynamic magnetic resonance imaging: feasibility of a robust and reliable measuring technique.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
08 10 2020
08 10 2020
Historique:
received:
28
02
2020
accepted:
28
08
2020
entrez:
9
10
2020
pubmed:
10
10
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Patellofemoral maltracking predisposes the patellofemoral joint to instability. The purpose of this study was to provide a reliable dynamic magnetic resonance imaging (MRI) measuring technique for patellofemoral maltracking, and to investigate the influence of anatomical risk factors (AF) on patellar maltracking. Ten patients (2 males,8 females, average 19 years) with clinical maltracking and 20 controls (10 males,10 females,average 28 years) were examined with a dynamic, multi-slice gradient-echo MRI sequence, during repetitive flexion(40°) and full extension, in an open-chain-active-movement. In a 30-s time frame three simultaneous transverse slices were acquired. Dynamic mediolateral translation and dynamic tilt were measured at defined positions, by two independent examiners. Reproducibility was tested in a set of five knees. Common AFs for patellar maltracking (tibial-tuberosity-to-trochlear-groove-(TT-TG)-distances, trochlea-sulcus-angle, trochlea-sulcus-depth, lateral-trochlear-inclination and Caton-Deschamps-Index) were analyzed in consensus, using standard static MRI sequences. In patients, dynamic mediolateral translation was significantly greater in patients (12.4 ± 6.9 mm vs. - 0.1 ± 2.3 mm, p < 0.001) and the patella was positioned significantly more laterally (17.5 ± 6.9 mm vs. 3.1 ± 2.4 mm, p < 0.001) compared to controls. During movement, the patella tilted 16.3 ± 13.1° laterally in patients and 1.9 ± 4.3° medially in controls (dynamic tilt) (p < 0.002). All AFs were significantly different between patients and controls. Pathological TT-TG-distances, Caton-Deschamps-Indices and trochlea-sulcus-angles strongly correlated with dynamic patellar translation and dynamic patellar tilt (p < 0.001). In the patient population, the primary pathologies for maltracking were lateralized-tibial-tubercle (n = 5), trochlea dysplasia n = 2, patella alta (n = 3). Interrater-reliability for translation and tilt-measurement was excellent (0.971/0.976, 95% CIs 0.939-0.986/0.950-0.988). Dynamic MRI reliably differentiates between abnormal and physiological patellar tracking. Dynamic tracking and tilt strongly correlate with measurable AFs, which reinforces their clinical use and validates the presented technique.
Identifiants
pubmed: 33033292
doi: 10.1038/s41598-020-72332-9
pii: 10.1038/s41598-020-72332-9
pmc: PMC7546634
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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