Arthroscopic assessment of patella tracking correlates with recurrent patellar instability.
Purpose: For recurrent lateral patellar instability surgical algorithm, an arthroscopic assessment of patellar tracking can aid with the decision of adding a tibial tubercle transfer procedure based on knee flexion angle at which patella centrally engages in its groove. Tibial tubercle-trochlear gro...
| Published in: | Knee Surgery, Sports Traumatology, Arthroscopy Vol. 28; no. 3; pp. 876 - 881 |
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| Main Authors: | , |
| Format: | Journal Article |
| Published: |
Wiley-Blackwell
Mar2020
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141881542&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141881542 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09422056 NRT jtl: Knee Surgery, Sports Traumatology, Arthroscopy issn: 09422056 maglogo: N pubinfo: dt: Mar2020 vid: 28 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 141881542 141881542 NLM31079162 10.1007/s00167-019-05532-0 NLM31079162 141881542 ppf: 876 ppct: 5 formats: tig: atl: Arthroscopic assessment of patella tracking correlates with recurrent patellar instability. aug: au: Kejriwal, Ritwik Annear, Peter affil: Taranaki Base Hospital, 87 Vivian St, 4310, New Plymouth, New Zealand sug: subj: Joint Instability Surgery Dislocations Physiopathology Knee Joint Surgery Joint Instability Physiopathology Dislocations Surgery Arthroscopy Methods Knee Joint Physiopathology Female Adult Young Adult Range of Motion Reproducibility of Results Patella Surgery Recurrence Male Tibia Surgery Prospective Studies Arthritis Impact Measurement Scales Adult: 19-44 years Female Male ab: Purpose: For recurrent lateral patellar instability surgical algorithm, an arthroscopic assessment of patellar tracking can aid with the decision of adding a tibial tubercle transfer procedure based on knee flexion angle at which patella centrally engages in its groove. Tibial tubercle-trochlear groove distance is variable in normal values and has discrepancies between imaging modalities. The aims of our study were to assess correlation of arthroscopic patellar tracking technique with recurrent patellar instability, and to assess the accuracy and reproducibility of this technique.Methods: 157 patients were evaluated, 64 control patients with no patellar instability, and 93 patients with recurrent patellar instability. This included 57 consecutive knee arthroscopy procedures evaluated for accuracy and reproducibility of our technique. The technique involved low flow arthroscopy and anterolateral viewing portal. Patients' knees were extended from a flexed position of 120°, and paused when the patella disengaged from its groove. The KFA was then estimated by the primary surgeon, and compared with a goniometer measurement. The assisting surgeon, blinded to the primary surgeon measurements, repeated this process. For the primary outcome, goniometer readings for KFA from the primary surgeon were used to correlate with patellar instability diagnosis.Results: Patients with patellar instability had a mean KFA of 118° compared to 44°for patients without patellar instability (p < 0.001). The mean difference between goniometer reading and estimation of KFA by each surgeon was 5° (p < 0.001) with intra-class correlation of 0.99. The mean difference between the two surgeons' goniometer readings was 8° (p < 0.001) with intra-class correlation of 0.99.Conclusion: This study confirms arthroscopic assessment of patella tracking is accurate, reproducible, and a knee flexion angle of greater than 44° correlates with patellar instability diagnosis. Patella tracking can be used as an adjunct or an alternative assessment method to tibial tubercle-trochlear groove distance to determine the need for tibial tubercle transfer in patellar stabilisation surgery.Level Of Evidence: Prospective Cohort Study, Level III. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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