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Updated: Dec 9, 2025

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Quantitative Variable Assessment of Patellar Instability: An MRI-Based Study.

Michael V Friedman1, Travis J Hillen1, Sunil Misra1

  • 1Washington University School of Medicine, Mallinckrodt Institute of Radiology, 510 S Kingshighway Blvd, St. Louis, MO 63110.

AJR. American Journal of Roentgenology
|September 9, 2020
PubMed
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Quantitative MRI parameters reliably assess anatomic predispositions for patellar instability. Trochlear dysplasia and tibial tubercle-to-trochlear groove distance are key indicators, aiding personalized orthopedic treatment strategies.

Area of Science:

  • Orthopedic imaging
  • Radiology
  • Biomedical engineering

Background:

  • Patellar instability is a complex condition with multifactorial causes.
  • Quantitative MRI parameters are increasingly used to assess anatomical predispositions.
  • Reproducibility of these measurements is crucial for clinical application.

Purpose of the Study:

  • To evaluate the reproducibility of three quantitative MRI parameters for patellar instability.
  • To determine if these parameters individually or collectively predict patellar instability.
  • To assess their role in identifying anatomical predisposition.

Main Methods:

  • Retrospective analysis of MRI scans from 100 patellar dislocation patients and 100 controls.
  • Measurement of tibial tubercle-to-posterior cruciate ligament (TT-PCL) distance, tibial tubercle-to-trochlear groove (TT-TG) distance, and TG depth (trochlear dysplasia).
Keywords:
kneepatellar instabilitytibial tubercle–trochlear groovetrochlear dysplasia

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  • Intraobserver and interobserver reliability assessed using intraclass correlation coefficients (ICC).

    • Main Results:

    • All three MRI parameters demonstrated high intraobserver (ICC ≥ 0.88) and interobserver (ICC ≥ 0.82) reliability.
    • Parameters were significantly more prevalent in the patellar instability group.
    • Trochlear dysplasia showed the strongest association, especially with abnormal TT-TG distance.

    Conclusions:

    • Quantitative MRI parameters for patellar instability are highly reproducible.
    • These parameters identify unique and overlapping anatomical predispositions.
    • Combined assessment of TT-PCL, TT-TG, and trochlear dysplasia aids in personalized patient management and surgical planning.