Referencing the trochlear groove based on three-dimensional computed tomography imaging improves the reliability of the measurement of the tibial tuberosity trochlear groove distance in patients with higher grades of trochlea dysplasia
- Authors
- Nha, KyungWook; Nam, Young Jun; Shin, Myung Jin; Sun, Seung Deok; Park, Jae Young; Debnath, Rajib; Lee, Byung Hoon
- Issue Date
- Dec-2019
- Publisher
- ELSEVIER
- Keywords
- Computed tomography; Patellar instability; Three-dimensional; Tibial tubercle-trochlear groove distance
- Citation
- KNEE, v.26, no.6, pp.1429 - 1436
- Journal Title
- KNEE
- Volume
- 26
- Number
- 6
- Start Page
- 1429
- End Page
- 1436
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/17927
- DOI
- 10.1016/j.knee.2019.05.001
- ISSN
- 0968-0160
- Abstract
- Background: To determine whether 3D-CT imaging technique is valid and reproducible compared to conventional CT measurement technique (CCT) for the detection of a femoropatellar Methods: Patients who had undergone surgery for femoropatellar instability (patellar instability group) between 2010 and 2016 (n = 37 knees of 35 patients) were retrospectively enrolled. For the matched control group, patients who had acute anterior cruciate ligament injury (<4 weeks previously; n = 30) were recruited. Preoperative CT data had been obtained in all patients. Inter-rater reliability was calculated for both measurement protocols, and inter-method reliability was calculated between the two imaging modalities. The results are reported using intraclass correlation coefficients (ICCs) and Bland-Altman 95% limits of agreement. Results: All patients in the patellar instability group had femoral trochlear dysplasia (Dejour types A: four, B: 19, C: seven, and D: six), but no dysplasia was noted in the control group. In the patellar instability group, the CCT technique showed a poor inter-rater agreement (ICC = 0.74), and the 3D-CT technique still showed excellent inter-rater agreement (ICCs = 0.91). In the sub-analysis of the patellar instability group according to the trochlear dyspiasia grade, ICCs were markedly decreased with severe trochlear dysplasia when using CCT technique; however, the 3D-CT technique could provide excellent reliability even with severe trochlear dysplasia. Conclusion: The 3D-CT imaging technique for the measurement of the TT-TG distance can be suggested as a better measurement technique for patellar instability patients with bone abnormality. (C) 2019 Elsevier B.V. All rights reserved.
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