1. Referencing the trochlear groove based on three-dimensional computed tomography imaging improves the reliability of the measurement of the tibial tuberosity–trochlear groove distance in patients with higher grades of trochlea dysplasia
- Author
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Young Jun Nam, Jae Young Park, Seung Deok Sun, Rajib Debnath, Byung Hoon Lee, Myung Jin Shin, and Kyung-Wook Nha
- Subjects
Joint Instability ,Male ,Adolescent ,Knee Joint ,Anterior cruciate ligament ,Tibial tuberosity ,Computed tomography ,Femoral trochlear dysplasia ,Trochlear groove ,Young Adult ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Humans ,Medicine ,Orthopedics and Sports Medicine ,In patient ,Retrospective Studies ,030222 orthopedics ,medicine.diagnostic_test ,business.industry ,Matched control ,Reproducibility of Results ,030229 sport sciences ,medicine.disease ,eye diseases ,medicine.anatomical_structure ,Dysplasia ,Case-Control Studies ,Female ,Tomography, X-Ray Computed ,business ,Nuclear medicine - Abstract
To determine whether 3D-CT imaging technique is valid and reproducible compared to conventional CT measurement technique (CCT) for the detection of a femoropatellar instability.Patients who had undergone surgery for femoropatellar instability (patellar instability group) between 2010 and 2016 (n = 37 knees of 35 patients) were retrospectively enrolled. For the matched control group, patients who had acute anterior cruciate ligament injury (4 weeks previously; n = 30) were recruited. Preoperative CT data had been obtained in all patients. Inter-rater reliability was calculated for both measurement protocols, and inter-method reliability was calculated between the two imaging modalities. The results are reported using intraclass correlation coefficients (ICCs) and Bland-Altman 95% limits of agreement.All patients in the patellar instability group had femoral trochlear dysplasia (Dejour types A: four, B: 19, C: seven, and D: six), but no dysplasia was noted in the control group. In the patellar instability group, the CCT technique showed a poor inter-rater agreement (ICC = 0.74), and the 3D-CT technique still showed excellent inter-rater agreement (ICCs = 0.91). In the sub-analysis of the patellar instability group according to the trochlear dysplasia grade, ICCs were markedly decreased with severe trochlear dysplasia when using CCT technique; however, the 3D-CT technique could provide excellent reliability even with severe trochlear dysplasia.The 3D-CT imaging technique for the measurement of the TT-TG distance can be suggested as a better measurement technique for patellar instability patients with bone abnormality.
- Published
- 2019