Redon TA, de la Rosa AM

Language: Spanish
References: 16
Page: 221-224
PDF size: 66.39 Kb.

ABSTRACT

An original radiologic method for diagnosis of patella alta is proposed. Present technique consists in plane frontal X-rays which are taken at a focal distance of one meter, to the knees in horizontal position of the patient while the quadriceps muscles are contracted and tight. This contraction allows the most proximal position of the patella, such as it occurs at the end of the swing phase of gait, which is tried to be reproduced by quadriceps contraction for X-rays. Comparison between 2 groups is carried out as follows: first group included 13 patients (26 knees), aged 12 to 65 years, av. 27, with painful patella alta. Second group included 40 military individuals, aged 17 to 27 years, av. 22, with asymptomatic 80 knees, considered as normal controls. Two horizontal parallel lines are designed on the X-rays, one is bicondylar and the other is tangential at the inferior border of the patella. Intercondilar-patellar distance (ICPD) wich is the distance between both lines was recorded. Results demonstrated an ICPD for symptomatic patients from +22 to +44 mm, average +30, while for normal individuals ICPD was from +4 to +32 mm, average +22. There was a difference of 8 mm in average between 2 groups, which means a difference of almost a centimeter in the lenght of the patellar ligament as well. As a rule, radiologic contour of the symptomatic patellae altae overrode the lateral contour of femur, which did not occurred in normal individuals.

REFERENCES

1. Blackburne JS, Peel TE. A new method for measuring the patella hight. J Bone Joint Surg 1977; 59b: 421.

2. Blumensaat C. Die Lageabweichungen und errenkungen der Kniescheibe. Ergeb. Chir Orthop 1938; 31: 149.

3. Boon-Itt B. The normal position of the patella. Am J Roentgen 1930; 24: 389.

4. Brattström H. Patella alta in non-dislocating knee joints. Acta Orthop Scand 1970; 41: 578.

5. Carvahlo. Citado por Muñoz.

6. Caton J, Deschamps G, Chambart P, Larat JL, Dejour H. Les rotules basses, a propos de 128 observations. Rev Chir Orthop 1982; 68: 317.

7. De la Rosa M, Redon TA. Determinación del desplazamiento proximal de la rótula mediante estudio radiológico dinámico en proyección frontal. Tesis de especialidad en ortopedia y traumatología. Escuela Militar de Graduados de Sanidad. México. Universidad del Ejército y Fuerza Aérea, 1996.

8. Elias SG, Freeman MAR, Gockay EI. A correlative study of the geometry and anatomy of the distal femur. Clin Orthop 1990; 260: 98.

9. Grelsamer RP, Meadows S. The modified Insall-Salvati ratio for assessment of patellas hight. Clin Orthop 1992; 282: 170.

10. Insall JN, Salvati E. Patella position in the normal knee joint. Radiol 1971; 101: 101.

11. Jacobsen K, Bertheusen K. The vertical location of the patella fundamental views on the concept patella alta using a normal sample. Acta Orthop Scand 1974; 45: 436.

12. Labelle H, Lauren CA. Radiological investigation of normal and abnormal patellae. J Bone Joinr Surg 1975; 57B: 530.

13. Leung YF, Wai YL, Leung YC. Patella alta in Southern China. A new method of measurement. Int Orthop 1996; 20: 305.

14. Muñoz GJ. Atlas de mediciones radiográficas en ortopedia y traumatología. México, McGraw-Hill-Interamericana 1999: 227-228.

15. Norman O, Egund N, Ekelund L, Runow A. The vertical position of the patella. Acta Ortop Scand 1983; 54: 908.

16. Tachdjian MO. Pediatric Orthopaedics. Philadelphia. W.B. Saunders Company. 1972;1:723-735.