Literature DB >> 24114353

Assessment of in vivo loading history of the patellofemoral joint: a study combining patellar position, tilt, alignment and bone SPECT/CT.

Stephan N Schön1, Faik K Afifi, Helmut Rasch, Felix Amsler, Niklaus F Friederich, Markus P Arnold, Michael T Hirschmann.   

Abstract

PURPOSE: The current study investigates whether patella height and tilt or leg alignment influence the intensity values as well as the distribution pattern of single photon emission computerized tomography/computerized tomography (SPECT/CT) tracer uptake in the patellofemoral joint.
METHODS: 99mTc-HDP-SPECT/CT and radiographs of consecutive 84 knees were prospectively obtained. Lateral radiographs were analyzed in terms of patellar height, Insall-Salvati index and modified Insall-Salvati index. Skyline views were analyzed for Laurin's lateral patellofemoral angle. On long-leg radiographs, the mechanical leg alignment was classified as varus, valgus or neutral. SPECT/CT was analyzed for each anatomical region using a previously validated SPECT/CT localization and grading algorithm. Mean, standard deviation, minimum and maximum of grading for each area of the localization scheme were recorded. Nonparametric Spearman's correlations were used to correlate patellar height, lateral patellar angle and leg alignment with the tracer uptake intensity. Chi-square statistics were used for categorical data (p < 0.05).
RESULTS: A patella baja correlated significantly with higher SPECT/CT tracer uptake in all patellar and lateral femoral regions (p < 0.001). A higher lateral patellar tilt correlated significantly with higher tracer uptake in the superior lateral femoral parts and the tibial tubercle. In mechanically varus aligned knees, there was significantly higher SPECT/CT tracer uptake on the medial and in valgus knees on the lateral part of the patellofemoral joint (p < 0.05).
CONCLUSIONS: As the intensity and distribution of the SPECT/CT significantly correlated with patella baja and patellar tilt, SPECT/CT might be considered as imaging modality for evaluating patients with patellofemoral disorders and for follow-up of patients after patellofemoral realignment procedures. LEVEL OF EVIDENCE: Diagnostic study, Level II.

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Year:  2013        PMID: 24114353     DOI: 10.1007/s00167-013-2698-2

Source DB:  PubMed          Journal:  Knee Surg Sports Traumatol Arthrosc        ISSN: 0942-2056            Impact factor:   4.342


  35 in total

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Journal:  Arthritis Care Res (Hoboken)       Date:  2010-09       Impact factor: 4.794

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Authors:  T Sasaki; T Yagi
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Authors:  Grace H Lo; David J Hunter; Yuqing Zhang; Christine E McLennan; Michael P Lavalley; Douglas P Kiel; Robert R McLean; Harry K Genant; Ali Guermazi; David T Felson
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4.  Radiographic analysis of patellar tilt.

Authors:  R P Grelsamer; A N Bazos; C S Proctor
Journal:  J Bone Joint Surg Br       Date:  1993-09

5.  Radiographic measures of knee alignment in patients with varus gonarthrosis: effect of weightbearing status and associations with dynamic joint load.

Authors:  Adrian V Specogna; Trevor B Birmingham; Michael A Hunt; Ian C Jones; Thomas R Jenkyn; Peter J Fowler; J Robert Giffin
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6.  Functional outcome after tibial tubercle transfer for the painful patella alta.

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7.  The abnormal lateral patellofemoral angle: a diagnostic roentgenographic sign of recurrent patellar subluxation.

Authors:  C A Laurin; H P Lévesque; R Dussault; H Labelle; J P Peides
Journal:  J Bone Joint Surg Am       Date:  1978-01       Impact factor: 5.284

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Authors:  R Singerman; D T Davy; V M Goldberg
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9.  The association between patellar alignment and patellofemoral joint osteoarthritis features--an MRI study.

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10.  Standardized volumetric 3D-analysis of SPECT/CT imaging in orthopaedics: overcoming the limitations of qualitative 2D analysis.

Authors:  Michael T Hirschmann; Christopher R Wagner; Helmut Rasch; Johann Henckel
Journal:  BMC Med Imaging       Date:  2012-03-29       Impact factor: 1.930

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10.  Alignment changes after open-wedge high tibial osteotomy result in offloading in the patellofemoral joint: a SPECT/CT analysis.

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