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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
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Dynamic tracking influenced by anatomy in patellar instability.

John J Elias1, Neil T Soehnlen2, Loredana M Guseila1

  • 1Department of Research, Cleveland Clinic Akron General, 1 Akron General Ave, Akron 44307, OH, USA.

The Knee
|February 29, 2016
PubMed
Summary

Anatomical factors like trochlear dysplasia and tibial tuberosity position influence patellar tracking in recurrent patellar instability. These relationships vary with knee flexion angles, aiding in risk assessment and surgical guidance.

Keywords:
Patellar instabilityPatellar trackingTibial tuberosityTrochlear dysplasia

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Medical Imaging

Background:

  • Recurrent patellar instability is a common orthopedic condition.
  • Understanding the anatomical contributors to abnormal patellar tracking is crucial for effective treatment.

Purpose of the Study:

  • To correlate specific anatomical parameters with in vivo patellar tracking in patients with recurrent patellar instability.
  • To investigate how these correlations change with knee flexion angles.

Main Methods:

  • Utilized computational reconstruction from dynamic CT scans of eight subjects with recurrent patellar instability.
  • Analyzed patellar tracking (bisect offset index, lateral tilt) and anatomical parameters (lateral trochlear inclination, lateral TT-PCL distance, Caton-Deschamps index).
  • Employed multivariable linear regression to assess relationships at low and high flexion angles.

Main Results:

  • At low flexion, lateral trochlear inclination and lateral TT-PCL distance correlated with bisect offset index (p=0.02).
  • Lateral trochlear inclination significantly correlated with lateral tilt (p<0.001) at low flexion.
  • At high flexion, bisect offset index and lateral tilt correlated only with lateral TT-PCL distance (p≤0.02).

Conclusions:

  • Both trochlear dysplasia and tibial tuberosity position are linked to patellar tracking.
  • The influence of these anatomical parameters on patellar tracking is dependent on knee flexion angle.
  • These findings can inform risk assessment and surgical strategies for patellar instability.