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Patellar malalignment: a new method on knee MRI.
Hülya Kurtul Yildiz1, Elif Evrim Ekin1
1Radiology Department, Gaziosmanpaşa Taksim Training and Research Hospital, Istanbul, Turkey.
Patellar malalignment is often linked to trochlear dysplasia. A new MRI method using the medial patellofemoral ligament (MPFLL) to lateral patellar retinaculum (LPR) ratio can effectively detect this condition.
Area of Science:
- Orthopedic imaging and biomechanics.
- Knee joint anatomy and pathology.
Background:
- Patellar malalignment is a common orthopedic issue.
- Trochlear dysplasia is a significant risk factor for patellar instability.
Purpose of the Study:
- To assess the medial patellofemoral ligament (MPFLL)/lateral patellar retinaculum (LPR) ratio for detecting patellar malalignment.
- To evaluate the prevalence of trochlear dysplasia types in patients with patellar malalignment.
Main Methods:
- Retrospective analysis of 450 knee MRIs (1.5T).
- Investigated trochlear type, sulcus angle, MPFLL, LPR, and patellar height.
- Dejour classification used for trochlear dysplasia; kappa test for radiologist concordance.
Main Results:
- Prevalence of patellar malalignment and trochlear dysplasia was 34.7% and 63.7%, respectively.
- 97.2% of malalignment cases were associated with trochlear dysplasia.
- MPFLL/LPR ratio of 1.033-1.041 showed high sensitivity and specificity for malalignment.
Conclusions:
- Trochlear dysplasia frequently coexists with patellar malalignment.
- Increased MPFLL/LPR ratio on MRI is a novel, quantitative method for detecting patellar malalignment.
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