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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Arthroscopic assessment of patellofemoral tracking predicts patellar instability
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Arthroscopic assessment of patellofemoral tracking predicts patellar instability

机译：tell骨股骨关节镜检查评估可预测in骨不稳定

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Objectives: Surgical management of patellar instability includes proximal realignment procedure such as MPFL reconstruction. The decision to add a distal realignment procedure of tibial tubercle transfer is based on severity of patellar instability judged on either TTTG distance or arthroscopic patellofemoral tracking. We set out to validate our use of arthroscopic patellofemoral tracking for patellar instability management algorithm by analyzing its reproducibility and whether it correlates with patellar instability. Methods: A prospective observational study was carried out at Perth Orthopaedic and Sports Medicine Centre. Patient clinical presentations were divided into three groups - patellofemoral instability, patellofemoral pain, and no patellofemoral symptoms. Standard technique included low flow arthroscopy with single anterolateral viewing portal. Height of the fluid bag and presence of a knee holder was recorded. Knee flexion angle where patella first centrally engages in the trochlear groove was defined as Patellofemoral Congruent Angle (PCA). PCA was estimated by the primary surgeon and the angle was confirmed using a sterile goniometer. A second surgeon, blinded to the initial assessment, then repeated the measurements. Surgeon estimation error, interobserver reliability, and correlation with clinical presentation was analysed. Results: 57 knees were assessed for interobserver reliability. Intra-class correlation was 0.994 between surgeon’s estimate and goniometer reading. Intra-class correlation was 0.992 between the two surgeon’s readings suggesting a very high correlation. 157 patients had their PCA recorded and compared with their diagnosis. Mean PCA was 40 degrees in normal patients, and 118 degrees in patellar instability (p-value <0.001). Conclusion: Arthroscopic assessment of patellofemoral tracking is reproducible and correlates with patellar instability. A cut-off value of 40 degrees is recommended to differentiate normal tracking from abnormal.
机译：目的：of骨不稳的外科手术处理包括近端重整程序，例如MPFL重建。添加胫骨结节远端复位术的决定是基于根据TTTG距离或关节镜检查pa股关节追踪判断的pa骨不稳的严重程度。我们着手通过分析其可再现性及其是否与pa骨不稳定性相关联，来验证将关节镜下scopic股追踪用于for骨不稳定性管理算法的有效性。方法：在珀斯骨科和运动医学中心进行了一项前瞻性观察研究。患者的临床表现分为三组-股of不稳定，pa股疼痛和无pa股症状。标准技术包括具有单个前外侧观察门的低流量关节镜检查。记录液体袋的高度和膝盖保持器的存在。 ella骨首先在中央进入滑车槽的膝部屈曲角度定义为Pat股股骨后角（PCA）。 PCA由主治医师估计，并使用无菌测角仪确认角度。第二位外科医生对初始评估不知情，然后重复了测量。分析了外科医生的估计误差，观察者之间的可靠性以及与临床表现的相关性。结果：评估了57个膝盖的观察者之间的可靠性。术者估计与测角仪读数之间的类内相关为0.994。两位医生的读数之间的类内相关性为0.992，表明相关性非常高。记录了157例PCA并与诊断进行了比较。正常患者的平均PCA为40度，pa骨不稳定度为118度（p值<0.001）。结论：关节镜检查assessment骨股骨追踪是可重复的，并且与pa骨不稳相关。建议将截止值设为40度，以区分正常跟踪和异常跟踪。

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