Geraghty L, Humphries D, Fitzpatrick J. Assessment of the reliability and validity of imaging measurements for patellofemoral instability: an updated systematic review.
Skeletal Radiol 2022;
51:2245-56. [PMID:
35794393 DOI:
10.1007/s00256-022-04110-9]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE
To provide an update on the reliability and validity of all radiological measures used to assess patients presenting with patellofemoral instability.
METHODS
A search of the CINHAL, EMBASE, MEDLINE, and SCOPUS databases and the Cochrane library was conducted. All studies assessing the validity, reliability, sensitivity, and specificity of radiological measures of the patellofemoral joints of patients with patellofemoral instability from 2010 onwards were considered for inclusion. Discrimination validity, inter- and intra-observer reliability, and the sensitivity and specificity of specific imaging measures were evaluated.
RESULTS
Seventy-three studies met the selection criteria and were included for analysis. We identified eight radiological measures in four categories with good reliability and validity: the tibial tubercle to trochlear groove distance, specific measures of patellar height (Blackburne-Peel index, Caton-Deschamps index and Insall-Salvati ratios), three measures of trochlear dysplasia (sulcus angle, trochlear depth, and lateral trochlear inclination), and the tibial tubercle to posterior cruciate ligament distance. No included studies examined the reliability and validity of patellofemoral instability ultrasound measures.
CONCLUSION
Our updated review demonstrated good inter- and intra-observer reliability and discrimination validity for the tibial tubercle-trochlear groove distance, specific patellar height, and trochlear dysplasia measures on MRI. The tibial tubercle to posterior cruciate ligament distance, an indirect measure of rotational asymmetry, was a valid and reliable measure on MRI. Due to a lack of assessments across more than one study, there are a variety of proposed measures with insufficient evidence to determine their validity, reliability, sensitivity, and specificity.
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