Characteristics of Patellofemoral Measurement in Indonesian Population Using Magnetic Resonance Imaging

Sholahuddin Rhatomy; Kurniawan  Silalahi; Anggaditya  Putra; Nolli  Kresonni

doi:10.3889/oamjms.2021.5602

Authors

Sholahuddin Rhatomy Department of Orthopaedics and Traumatology, Dr. Soeradji Tirtonegoro General Hospital, Klaten, Indonesia/Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Kurniawan Silalahi Department of Orthopaedics and Traumatology, Putri Hijau Army Hospital, Medan, Indonesia
Anggaditya Putra Department of Orthopaedics and Traumatology, Fatmawati General Hospital, Jakarta, Indonesia
Nolli Kresonni Department of Radiology, Indriati Hospital, Sukoharjo, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.5602

Keywords:

Insall-Salvati ratio, Caton-deschamps index, Trochlear angle, Lateral trochlear inclination, Tibia tubercle-trochlear groove distance, Trochlear depth, Indonesian

Abstract

BACKGROUND: The patellofemoral join is a unique complex joint formed by articulation of the patella and the femoral trochlea. Normal measures for patellofemoral parameters have been published.

AIM: This study aimed to describe the characteristics of patellofemoral measurements in Indonesian population using magnetic resonance imaging (MRI).

METHODS: This descriptive total sampling study was conducted from May 2019 to August 2020. The parameters of the measurements in this study include Insall-Salvati ratio, Caton-Deschamps index, trochlear angle, lateral trochlear inclination, TT (tibia tubercle) – TG (trochlear groove) distance, and trochlear depth. The mean results of the measurements were compared with the normal value measurements that are internationally used.

RESULTS: A total of 100 normal knees MRI scan from patients consisting of 54 (54%) males and 46 (46%) females, with an average age of 35.09 ± 12.77 (19–60) years old. The average body mass index (BMI) was 28.07 ± 3.0 (22–34). Based on ethnicity, subjects were mostly Javanese (66%), Sundanese (12%), Madura (4%), Minangkabau (7%), and the others (11%). The mean of Insall-Salvati ratio was 1.09 ± 0.17 (0.49–1.60). The mean of Caton-Deschamps index was 0.97 ± 0.16 (0.62–1.64). The mean of trochlear angle was 138.97° ± 119.7 (122°–160°). The mean of lateral trochlear inclination was 20.37° ± 4.56 (11.0°–30.6°). The mean of TT-TG distance was 13.76 ± 5.86 (4.9–41), and the mean of trochlear depth was 5.18 ± 1.87 (1.05–8.6). Those values were within normal range of international values. There were no significant differences between comparison of males and females.

CONCLUSION: The means of Insall-Salvati ratio, Caton-Deschamps index, trochlear angle, lateral trochlear inclination, and TT-TG trochlear depth of the Indonesian people were within the international normal range, and higher than other countries’ published measurements.

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References

Purohit N, Hancock N, Saifuddin A. Surgical management of patellofemoral instability. I. Imaging considerations. Skeletal Radiol. 2019;48(6):859-69. https://doi.org/10.1007/s00256-018-3123-1 PMid:30542758

Yu Z, Yao J, Wang X, Xin X, Zhang K, Cai H, et al. Research methods and progress of patellofemoral joint kinematics: A review. J Healthc Eng. 2019;2019:9159267. PMid:31019669

Loudon JK. Biomechanics and pathomechanics of the patellofemoral joint. Int J Sports Phys Ther. 2016;11(6):820-30. PMid:27904787

Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports Med. 2010;29(3):379-98. PMid:20610028

Luyckx T, Didden K, Vandenneucker H, Labey L, Innocenti B, Bellemans J. Is there a biomechanical explanation for anterior knee pain in patients with patella alta?: Influence of patellar height on patellofemoral contact force, contact area and contact pressure. J Bone Joint Surg Br. 2009;91(3):344-50. https://doi.org/10.1302/0301-620x.91b3.21592 PMid:19258610

Tanaka MJ, Cosgarea AJ. Measuring malalignment on imaging in the treatment of patellofemoral instability. Am J Orthop (Belle Mead NJ). 2017;46(3):148-51. PMid:28666038

Escala JS, Mellado JM, Olona M, Giné J, Saurí A, Neyret P. Objective patellar instability: MR-based quantitative assessment of potentially associated anatomical features. Knee Surg Sports Traumatol Arthrosc. 2006;14(3):264-72. https://doi.org/10.1007/s00167-005-0668-z PMid:16133440

Elias DA, White LM. Imaging of patellofemoral disorders. Clin Radiol. 2004;59(7):543-57. PMid:15208060

Macri EM, Felson DT, Zhang Y, Guermazi A, Roemer FW, Crossley KM, et al. Patellofemoral morphology and alignment: Reference values and dose-response patterns for the relation to MRI features of patellofemoral osteoarthritis. Osteoarthritis Cartilage. 2017;25(10):1690-7. https://doi.org/10.1016/j.joca.2017.06.005 PMid:28648740

Endo Y, Stein BE, Potter HG. Radiologic assessment of patellofemoral pain in the athlete. Sports Health. 2011;3(2):195- 210. https://doi.org/10.1177/1941738110397875 PMid:23016009

Verhulst FV, van Sambeeck JD, Olthuis GS, van der Ree J. Patellar height measurements: Insall-salvati ratio is most reliable method. Knee Surg Sports Traumatol Arthrosc. 2020;28(3):869- 75. https://doi.org/10.1007/s00167-019-05531-1 PMid:31089790

Narkbunnam R, Chareancholvanich K. Effect of patient position on measurement of patellar height ratio. Arch Orthop Trauma Surg. 2015;135(8):1151-6. https://doi.org/10.1007/s00402-015-2268-9 PMid:26138208

Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: An anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc. 1994;2(1):19-26. https://doi.org/10.1007/bf01552649 PMid:7584171

Carrillon Y, Abidi H, Dejour D, Fantino O, Moyen B, van Tran- Minh A. Patellar instability: Assessment on MR images by measuring the lateral trochlear inclination-initial experience. Radiology. 2000;216(2):582-5. https://doi.org/10.1148/radiology.216.2.r00au07582 PMid:10924589

Pfirrmann CW, Zanetti M, Romero J, Hodler J. Femoral trochlear dysplasia: MR findings. Radiology. 2000;216(3):858-64. https:// doi.org/10.1148/radiology.216.3.r00se38858 PMid:10966723

Alemparte J, Ekdahl M, Burnier L, Cardemil A, Cielo R, Danilla S, et al. Patellofemoral evaluation with radiographs and computed tomography scans in 60 knees of asymptomatic subjects. Arthroscopy. 2007;23(2):170-7. https://doi.org/10.1016/j.arthro.2006.08.022 PMid:17276225

Song EK, Seon JK, Kim MC, Seol Y, Lee SH. Radiologic measurement of tibial tuberosity-trochlear groove (TT-TG) distance by lower extremity rotational profile computed tomography in Koreans. Clin Orthop Surg. 2016;8(1):45-8. https://doi.org/10.4055/cios.2016.8.1.45 PMid:26929798

Raja BS, Mohan H, Jain AM, Gautham S. Computed tomography-based analysis of tibial tuberosity-trochlear groove distance in Indian population. Cureus. 2019;11(7):e5277. https://doi.org/10.7759/cureus.5277 PMid:31576269

Mustamsir E, Phatama KY, Pratianto A, Abduh M, Hidayat M. Validity and reliability of the Indonesian version of the Kujala score for patients with patellofemoral pain syndrome. Orthop J Sports Med. 2019;8(5):1-5. https://doi.org/10.1177/2325967120922943 PMid:32523969

Joko A, Triwahyudi H. Dinamika perkembangan etnis di Indonesia dalam konteks persatuan negara. Populasi. 2017;25(1):64-81. https://doi.org/10.22146/jp.32416

Resorlu H, Zateri C, Nusran G, Goksel F, Aylanc N. The relation between chondromalacia patella and meniscal tear and the sulcus angle/trochlear depth ratio as a powerful predictor. J Back Musculoskelet Rehabil. 2017;30(3):603-8. https://doi.org/10.3233/bmr-160536 PMid:27911285

Hsu CP, Lee PY, Wei HW, Lin SC, Lu YC, Lin JC, et al. Gender differences in femoral trochlea morphology. Knee Surg Sports Traumatol Arthrosc. 2020;2020:1-10. https://doi.org/10.1007/s00167-020-05944-3 PMid:32232538