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Kwak YH, Park SS, Huser AJ, Kim K, Koh YG, Nam JH, Kang KT. Reliability and modality analysis of patellar height measurement in pediatric knee. Front Pediatr 2024; 12:1323015. [PMID: 38596246 PMCID: PMC11002117 DOI: 10.3389/fped.2024.1323015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Various measurement methods and imaging technique are in use to measure patellar height in pediatric patients. However, there is no gold standard as to which measurement method and modality are the most reliable for pediatric patients. Therefore, the aim of this study was to determine the inter-observer reliability, intra-observer reliability, and applicability of various patellar height measurement methods in pediatric knee. Additionaly, we analyzed the reliability across different imaging modalities. Methods Total 450 pediatric patients (age: 5-18 years) were evaluated using lateral knee radiographs and magnetic resonance imaging (MRI). The patellar height ratios were measured using five methods. Five methods were Insall-Salvati (IS), Koshino-Sugimoto (KS), Blackburne-Peel (BP), modified Insall-Salvati (MIS), and Caton-Deschamps (CD). The patients were categorized into two age groups: P (ages 5-13) and Q (ages 14-18). Each measurement was conducted twice by two raters. The intra-observer reliability, inter-observer reliability and inter-modality reliability were calculated. In addition, applicability was defined as the possibility to apply each measurement method to each age group. Results The KS method showed the highest inter-observer reliability and intra-observer reliability when using MRI for both age groups. The inter-observer reliability and intra-observer reliability of the IS for lateral knee radiographs was highest among all observers for group Q. The CD method showed the highest inter-observer reliability in group P, while the KS showed the highest intra-observer reliability in group P using lateral radiographs. The KS method showed the highest inter-modality reliability in group P, while the IS showed the highest inter-modality reliability in group Q. The KS method was applicable to all patients when using lateral knee radiography, and the IS method was applicable to all patients when using MRI. Conclusions Our results show that the reliability of various measurement method and imaging technique differed based on pediatric knee age group when measuring patellar height. Therefore, in the case of pediatric patients, reliability measurement methods and imaging techniques according to the patient's age should be applied.
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Affiliation(s)
- Yoon Hae Kwak
- Department of Orthopedic Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soo-Sung Park
- Department of Orthopedic Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Aaron J. Huser
- Department of Orthopedic Surgery, Paley Advanced Limb Lengthening Institute, St. Mary’s Hospital, West Palm Beach, FL, United States
| | - Keunho Kim
- Department of Orthopedic Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong-Gon Koh
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea
| | - Ji-Hoon Nam
- Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea
| | - Kyoung-Tak Kang
- Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea
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Snow M, Singh N, Rix L, Haikal M. No Correlation Exists Between Tibial- and Femoral-Based Measurements of Patella Alta in a Population With Chronic Patellofemoral Pain or Instability Undergoing Patella Distalization. Arthroscopy 2024:S0749-8063(24)00092-6. [PMID: 38340969 DOI: 10.1016/j.arthro.2024.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To investigate whether the patellotrochlear index (PTI) predicts patella alta as determined by tibial-based methods of Insall-Salvati (IS) and Caton-Deschamp (CDI) indexes in a pathological population (with patellofemoral pain and/or instability), in addition to determining whether PTI and sagittal patellofemoral engagement (SPE) correlate with trochlea length as determined by lateral condyle index (LCI). METHODS Patients with confirmed patella alta (IS/CDI ratio >1.2) undergoing tibial tubercle osteotomy for patellofemoral pain/instability with an available magnetic resonance imaging (MRI) scans were included. Patients who had undergone previous soft-tissue realignment, previous surgery, or trauma to the extensor mechanism were excluded. Two raters measured the IS, CDI, PTI, SPE, LCI, and knee flexion angle (KFA) on MRI. Interobserver reliability and correlation between measurements were calculated. RESULTS In total, 71 knees were included. PTI (0.73), SPE (0.836), LCI (0.701), and KFA (0.8) demonstrated good- to near-excellent interobserver reliability. IS (0.65) and CDI (0.66) demonstrated moderate interobserver reliability. PTI and SPE showed the strongest significant correlation (0.8112, P = 2.2 × 10-16). IS and CD (0.39, P = .0007) showed a moderate significant correlation. PTI and KFA (0.53, P = 1.685 × 10-6) and SPE and KFA (0.61, P = 1.991 × 10-8) had a significant moderate correlation. LCI and KFA (-0.37, P = .0017) showed a significant moderate negative correlation. All other measurement indices correlated poorly and were insignificant. A total of 94.4% of the knees were defined as having patella alta using IS, with the remaining 5.6% having a raised CDI. Only 14% of cases had an IS of >1.2, a CDI >1.2, and a PTI <0.125, which increased to 39% (28/71) when the threshold for PTI was increased to <0.28. CONCLUSIONS There was no correlation between tibial (IS and CD) and femoral methods (PTI and SPE) of quantifying patella alta. PTI and SPE did not correlate with trochlea length as measured by LCI. PTI, SPE, and LCI are significantly affected by the KFA during MRI. LEVEL OF EVIDENCE Level IV, retrospective diagnostic radiographic investigation.
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Affiliation(s)
- Martyn Snow
- The Royal Orthopaedic Hospital, Birmingham, United Kingdom; Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust, Oswestry, United Kingdom; Centre for Regenerative Medicine Research, Keele University, Staffordshire, United Kingdom
| | - Nishant Singh
- Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust, Oswestry, United Kingdom
| | - Larissa Rix
- Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust, Oswestry, United Kingdom; Centre for Regenerative Medicine Research, Keele University, Staffordshire, United Kingdom
| | - Mohammad Haikal
- The Royal Orthopaedic Hospital, Birmingham, United Kingdom; Tanta University, Tanta, Egypt.
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Shankar DS, Avila A, DeClouette B, Vasavada KD, Jazrawi IB, Alaia MJ, Gonzalez-Lomas G, Strauss EJ, Campbell KA. Home ownership, full-time employment, and other markers of higher socioeconomic status are predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction. Knee Surg Relat Res 2023; 35:20. [PMID: 37461119 DOI: 10.1186/s43019-023-00193-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The purpose of this study was to identify socioeconomic predictors of time to initial evaluation, time to surgery, and postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction (MPFLR). METHODS We conducted a retrospective review of patients at our institution who underwent primary MPFLR with allograft from 2011 to 2019 and had minimum 12-month follow-up. Patients were administered an email survey in January 2022 to assess symptom history, socioeconomic status, and postoperative outcomes including VAS satisfaction and Kujala score. Predictors of time to initial evaluation, time to surgery, and postoperative outcomes were identified using multivariable linear and logistic regression with stepwise selection. RESULTS Seventy patients were included in the cohort (mean age 24.8 years, 72.9% female, mean follow-up time 45.7 months). Mean time to evaluation was 6.4 months (range 0-221) and mean time to surgery was 73.6 months (range 0-444). Having a general health check-up in the year prior to surgery was predictive of shorter time to initial evaluation (β = - 100.5 [- 174.5, - 26.5], p = 0.008). Home ownership was predictive of shorter time to surgery (β = - 56.5 [- 104.7, 8.3], p = 0.02). Full-time employment was predictive of higher VAS satisfaction (β = 14.1 [4.3, 23.9], p = 0.006) and higher Kujala score (β = 8.7 [0.9, 16.5], p = 0.03). CONCLUSION Markers of higher socioeconomic status including having a general check-up in the year prior to surgery, home ownership, and full-time employment were predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes. LEVEL OF EVIDENCE IV, retrospective case series.
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Affiliation(s)
- Dhruv S Shankar
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA.
| | - Amanda Avila
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Brittany DeClouette
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Kinjal D Vasavada
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Isabella B Jazrawi
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Michael J Alaia
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Guillem Gonzalez-Lomas
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Eric J Strauss
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Kirk A Campbell
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
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Watts RE, Gorbachova T, Fritz RC, Saad SS, Lutz AM, Kim J, Chaudhari AS, Shea KG, Sherman SL, Boutin RD. Patellar Tracking: An Old Problem with New Insights. Radiographics 2023; 43:e220177. [PMID: 37261964 PMCID: PMC10262599 DOI: 10.1148/rg.220177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 06/03/2023]
Abstract
Patellofemoral pain and instability are common indications for imaging that are encountered in everyday practice. The authors comprehensively review key aspects of patellofemoral instability pertinent to radiologists that can be seen before the onset of osteoarthritis, highlighting the anatomy, clinical evaluation, diagnostic imaging, and treatment. Regarding the anatomy, the medial patellofemoral ligament (MPFL) is the primary static soft-tissue restraint to lateral patellar displacement and is commonly reconstructed surgically in patients with MPFL dysfunction and patellar instability. Osteoarticular abnormalities that predispose individuals to patellar instability include patellar malalignment, trochlear dysplasia, and tibial tubercle lateralization. Clinically, patients with patellar instability may be divided into two broad groups with imaging findings that sometimes overlap: patients with a history of overt patellar instability after a traumatic event (eg, dislocation, subluxation) and patients without such a history. In terms of imaging, radiography is generally the initial examination of choice, and MRI is the most common cross-sectional examination performed preoperatively. For all imaging techniques, there has been a proliferation of published radiologic measurement methods. The authors summarize the most common validated measurements for patellar malalignment, trochlear dysplasia, and tibial tubercle lateralization. Given that static imaging is inherently limited in the evaluation of patellar motion, dynamic imaging with US, CT, or MRI may be requested by some surgeons. The primary treatment strategy for patellofemoral pain is conservative. Surgical treatment options include MPFL reconstruction with or without osseous corrections such as trochleoplasty and tibial tubercle osteotomy. Postoperative complications evaluated at imaging include patellar fracture, graft failure, graft malposition, and medial patellar subluxation. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Robert E. Watts
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Tetyana Gorbachova
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Russell C. Fritz
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Sherif S. Saad
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Amelie M. Lutz
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Jiyoon Kim
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Akshay S. Chaudhari
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Kevin G. Shea
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Seth L. Sherman
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
| | - Robert D. Boutin
- From the Departments of Radiology (R.E.W., A.M.L., R.D.B.) and
Orthopaedic Surgery (S.L.S.), Stanford University School of Medicine, 300
Pasteur Dr, Stanford, CA 94305-5101; Department of Radiology, Einstein
Healthcare Network and Jefferson Health, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA (T.G.); Department of Musculoskeletal
Radiology, National Orthopedic Imaging Associates, Greenbrae, CA (R.C.F.);
Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ
(S.S.S.); Department of Radiology, Benning Martin Army Community Hospital, Fort
Benning, GA (J.K.); Departments of Radiology and Biomedical Data Science,
Stanford University, Stanford, CA (A.S.C.); and Department of Orthopaedic
Surgery, Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA
(K.G.S.)
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Kwak YH, Park SS, Huser AJ, Lim HW, Baki SWA, Koh YG, Nam JH, Kang KT. Evaluation of age group and sex differences in the measurement of patellar height of pediatric knee in a Korean population. Front Pediatr 2022; 10:1021147. [PMID: 36726999 PMCID: PMC9884835 DOI: 10.3389/fped.2022.1021147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/28/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Various methods based on bony landmarks are used to determine patellar height. This study analyzed five methods for patellar height measurement on lateral knee radiographs, namely, the Insall-Salvati, Koshino-Sugimoto, Blackburne-Peel, modified Insall-Salvati, and Caton-Deschamps methods. METHODS Overall, 425 pediatric participants (221 males, 204 females; age range 5-18 years) were included and were divided equally into three age groups (A, 5-10 years; B, 11-13 years; and C, 13-18 years). For the comparison of the applicability of each method, the applicable probabilities for each age group and sex-based differences were analyzed using logistic regression techniques. Intra-rater reliability and inter-rater variability were analyzed by two trained raters. RESULTS The Koshino-Sugimoto method was applicable to all patients. The 80% applicable age of female patients was lower than that of male patients for the Blackburne-Peel (male = 11.9, female = 11) and Caton-Deschamps (male = 11.9, female = 11.1) methods. However, in the Insall-Salvati (male = 12, female = 12.1) and modified Insall-Salvati (male = 12.6, female = 13.1) methods, the 80% applicable age in male patients was lower than that in female patients. The Koshino-Sugimoto method showed the highest variability in group B, while the Insall-Salvati showed the highest variability in group C. In terms of intra-observer reliability, the Caton-Deschamps method showed the same reliability as the Insall-Salvati method, in group C. CONCLUSIONS Our results demonstrated differences in the reliability, variability, and applicability of patellar height measurement methods according to age group. The applicability of patellar height measurement methods also differed according to sex. Therefore, based on age group and sex, different methods should be used for patellar height measurement in pediatric patients.
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Affiliation(s)
- Yoo Hae Kwak
- Department of Orthopedic Surgery, Asan Medical Center, Seoul, South Korea
| | - Soo-Sung Park
- Department of Orthopedic Surgery, Asan Medical Center, Seoul, South Korea
| | - Aaron J Huser
- Paley Advanced Limb Lengthening Institute, St. Mary's Hospital, West Palm Beach, FL, United States
| | - Hyo Won Lim
- Department of Orthopedic Surgery, Asan Medical Center, Seoul, South Korea
| | - Sharkawy Wagih Abdel Baki
- Department of Orthopedic Surgery, Aswan University Hospital, Aswan, Egypt.,Department of Orthopaedis Surgery, Severance Children's Hospital, Seoul, South Korea
| | - Yong-Gon Koh
- Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, South Korea
| | - Ji-Hoon Nam
- Department of Mechanical Engineering, Yonsei University, Seoul, South Korea
| | - Kyoung-Tak Kang
- Department of Mechanical Engineering, Yonsei University, Seoul, South Korea
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