Diagnostic value of CT cross-sectional measurements for patellar dislocation

doi:10.3877/cma.j.issn.1674-0785.2022.08.007

Abstract

Abstract:

Objective

To investigate the diagnostic value of knee cross-sectional CT measurements of tibial tuberosity-trochlear groove (TT-TG) distance, patellar tilt angle, and patellar deviation angle for patellar dislocation.

Methods

From 2013 to 2016, 153 patients with patellar dislocation and 151 controls at Peking University Third Hospital were analyzed retrospectively. TT-TG distance, patellar tilt angle, and patellar deviation angle were measured on axial CT images. The performance of TT-TG distance, patellar tilt angle, and patellar deviation angle in predicting patellar dislocation was assessed by the receiver operating characteristic (ROC) curve analysis.

Results

No significant difference was found between the two groups in age, sex, knee size, height, weight, Insall-Salvati index, femoral width, or tibial width. The mean TT-TG distance, patellar tilt angle, and patellar deviation angle in the patellar dislocation group were 19.4 mm, 27.5°, and 42.8°, respectively, which were significantly greater than those of the control group (12.2 mm, 11.5°, and 15.6°, respectively). ROC curve analysis suggested that TT-TG distance, patellar tilt angle, and patellar deviation angle could be efficient to diagnose patellar dislocation. All the three measurements had good value in diagnosing patellar dislocation, with the area under the curve values greater than 0.85, and their optimal cutoff values were 15.9, 20.8°, and 31.1°, respectively.

Conclusion

TT-TG distance, patellar tilt angle, and patellar deviation angle have high value in diagnosing patellar dislocation.

Key words: Patellar dislocation, Patellofemoral joint, Computed tomography

Haijun Wang, Yifan Song, Jiakuo Yu. Diagnostic value of CT cross-sectional measurements for patellar dislocation[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(08): 744-748.

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Figures/Tables 5

项目	髌骨脱位（n=153）	对照组（n=151）	P值
年龄（岁， $x ¯$ ±s）	22.1±6.5	22.7±5.9	0.360
性别［例（%）］			0.938
男性	48（31.4）	48（31.8）
女性	105（68.6）	103（68.2）
侧别［例（%）］			0.170
左	90（58.8）	77（51.0）
右	63（41.2）	74（49.0）
身高（cm， $x ¯$ ±s）	168.9±8.7	170.0±8.2	0.225
体重（kg， $x ¯$ ±s）	66.9±16.5	68.4±14.5	0.402
Insall指数（ $x ¯$ ±s）	1.15±0.18	1.07±0.14	0.154
股骨宽度（mm， $x ¯$ ±s）	76.7±6.5	77.5±5.7	0.266
胫骨宽度（mm， $x ¯$ ±s）	72.1±5.7	73.4±5.5	0.141
TT-TG（mm， $x ¯$ ±s）	19.4±4.4	12.2±4.1	＜0.001
髌骨倾斜角（°， $x ¯$ ±s）	27.5±8.3	11.5±6.4	＜0.001
髌骨外偏角（°， $x ¯$ ±s）	42.8±20.7	15.6±16.1	＜0.001

项目	髌骨脱位（n=153）	对照组（n=151）	P值
年龄（岁， $x ¯$ ±s）	22.1±6.5	22.7±5.9	0.360
性别［例（%）］			0.938
男性	48（31.4）	48（31.8）
女性	105（68.6）	103（68.2）
侧别［例（%）］			0.170
左	90（58.8）	77（51.0）
右	63（41.2）	74（49.0）
身高（cm， $x ¯$ ±s）	168.9±8.7	170.0±8.2	0.225
体重（kg， $x ¯$ ±s）	66.9±16.5	68.4±14.5	0.402
Insall指数（ $x ¯$ ±s）	1.15±0.18	1.07±0.14	0.154
股骨宽度（mm， $x ¯$ ±s）	76.7±6.5	77.5±5.7	0.266
胫骨宽度（mm， $x ¯$ ±s）	72.1±5.7	73.4±5.5	0.141
TT-TG（mm， $x ¯$ ±s）	19.4±4.4	12.2±4.1	＜0.001
髌骨倾斜角（°， $x ¯$ ±s）	27.5±8.3	11.5±6.4	＜0.001
髌骨外偏角（°， $x ¯$ ±s）	42.8±20.7	15.6±16.1	＜0.001

测量指标	OOP	AUC（95%可信区间）	P值	敏感度（%）	特异度（%）
TT-TG	15.9	0.89（0.85~0.93）	＜0.001	80.4	82.8
倾斜角	20.8	0.93（0.91~0.96）	＜0.001	79.1	94.0
外偏角	31.1	0.86（0.81~0.90）	＜0.001	76.5	87.4

测量指标	阈值	敏感度（%）	特异度（%）
TT-TG	≥20.0	48.4	96.7
TT-TG	≥19.4	49.7	96.0
TT-TG	≥15.0	85.0	75.5
髌骨倾斜角	≥27.5	51.6	98.0
髌骨外偏角	≥42.8	52.9	97.4

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