A modified system of stress radiography for patellofemoral instability

被引:15
作者
Fukui, N [1 ]
Nakagawa, T [1 ]
Murakami, S [1 ]
Hiraoka, H [1 ]
Nakamura, K [1 ]
机构
[1] Univ Tokyo, Dept Orthopaed Surg, Bunkyo Ku, Tokyo 1138655, Japan
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 2003年 / 85B卷 / 08期
关键词
D O I
10.1302/0301-620X.85B8.13538
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Axial radiographs were obtained under valgus and external rotation stress at 45degrees of knee flexion with and without contraction of the quadriceps muscle in order to assess the dynamics of patellar subluxation or dislocation. The radiography was performed on 82 knees in 61 patients with patellofemoral instability, and on 44 normal knees. The lateral patellofemoral angle and the congruence angle were measured and compared with the conventional Merchant views. Both parameters showed greater differences between symptomatic and normal knees on the stress radiographs obtained without quadriceps contraction. There was a major difference in the lateral patellofemoral angles between the groups, which clearly distinguished symptomatic knees from normal controls. Congruence angles on stress radiography had a significant correlation with the functional scores obtained after a period of conservative treatment and a positive correlation with the frequency of patellar subluxation. When the quadriceps contracted, two patterns of patellar shift were observed. While the patella reduced into the trochlear groove in all normal knees and about 70% of the symptomatic knees, contraction of the quadriceps caused further subluxation of the patella in the remaining symptomatic knees. All the knee joints which showed this displacement failed to respond to conservative treatment and eventually required surgical treatment. Thus, this technique of stress radiography is a simple, cost-effective and useful method of evaluating patellar instability and predicting the prognosis.
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页码:1128 / 1133
页数:6
相关论文
共 20 条
[1]
RADIOGRAPHIC ANALYSIS OF PATELLAR TILT [J].
GRELSAMER, RP ;
BAZOS, AN ;
PROCTOR, CS .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1993, 75 (05) :822-824
[2]
GRELSAMER RP, 1998, PATELLA TEAM APPROAC, P119
[3]
SUBLUXATION OF PATELLA [J].
HUGHSTON, JC .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1968, A 50 (05) :1003-&
[4]
HUGHSTON JC, 1989, CLIN SPORT MED, V8, P153
[5]
SUBLUXATION OF THE PATELLA - COMPUTED-TOMOGRAPHY ANALYSIS OF PATELLOFEMORAL CONGRUENCE [J].
INOUE, M ;
SHINO, K ;
HIROSE, H ;
HORIBE, S ;
ONO, K .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1988, 70A (09) :1331-1337
[6]
SCORING OF PATELLOFEMORAL DISORDERS [J].
KUJALA, UM ;
JAAKKOLA, LH ;
KOSKINEN, SK ;
TAIMELA, S ;
HURME, M ;
NELIMARKKA, O .
ARTHROSCOPY, 1993, 9 (02) :159-163
[7]
PATELLOFEMORAL RELATIONSHIPS IN RECURRENT PATELLAR DISLOCATION [J].
KUJALA, UM ;
OSTERMAN, K ;
KORMANO, M ;
NELIMARKKA, O ;
HURME, M ;
TAIMELA, S .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1989, 71 (05) :788-792
[8]
ABNORMAL LATERAL PATELLO-FEMORAL ANGLE - DIAGNOSTIC ROENTGENOGRAPHIC SIGN OF RECURRENT PATELLAR SUBLUXATION [J].
LAURIN, CA ;
LEVESQUE, HP ;
DUSSAULT, R ;
LABELLE, H ;
PEIDES, JP .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1978, 60 (01) :55-60
[9]
PATELLOFEMORAL JOINT - 30-DEGREES AXIAL RADIOGRAPH WITH LATERAL ROTATION OF THE LEG [J].
MALGHEM, J ;
MALDAGUE, B .
RADIOLOGY, 1989, 170 (02) :566-567
[10]
STIFFNESS AND LAXITY OF KNEE - CONTRIBUTIONS OF SUPPORTING STRUCTURES - QUANTITATIVE INVITRO STUDY [J].
MARKOLF, KL ;
MENSCH, JS ;
AMSTUTZ, HC .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1976, 58 (05) :583-594