+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Correlation of radiographic patellofemoral indices with tibial tubercle transfer distance in Fulkerson osteotomy procedures

, : Correlation of radiographic patellofemoral indices with tibial tubercle transfer distance in Fulkerson osteotomy procedures. Iowa Orthopaedic Journal 34(): 24-29

A laterally tracking patella is commonly seen in patients with chronic recurrent lateral patellar dislocations. Clinical appearance of the J-sign occurs when the patella is congruent with the trochlear groove in flexion and moves over the lateral border of the femoral condyle as the lower leg reaches complete extension. A Fulkerson osteotomy procedure corrects this maltracking of the patella by medially transferring the tibial tubercle. There are many radiographic patellofemoral indices that can be used describe this incongruence about the patelloformal joint. The current literature supports the use of the tibial tubercle-trochlear groove (TT-TG) index in determining the appropriate amount medialization of the extensor mechanism. However there is little agreement in how far to transfer the tibial tubercle to best achieve maximum patello-femoral congruency. It is the senior author's belief that lateral patellar edge (LPE) measure on voluntary quadriceps active hyperextension MRI scan has the strongest correlation with final operative tibial tubercle transfer distance needed to achieve maximum patellofemoral congruency. The purpose of this study was to show that the voluntary quadriceps active hyperextension MRI measurement of lateral patellar edge (LPE) has the strongest correlation with tibial tubercle transfer distance required to achieve maxium patellofemoral congruency intraoperatively in the terminal 30 degrees of active knee extension compared to all other patellofemoral indices measured on axial MRI scans with the knee in voluntary active knee extension to 30 degrees of flexion, passive full extension, and voluntary quadriceps active hyperextension. Retrospective case series via review of the electronic medical record. Forty-three Fulkerson osteotomy patient charts were reviewed retrospectively. Three different pre-operative axial MRI views were then examined and measured for Tibial Tubercle-Trochlear Groove (tt-tg), lateral patellar edge (LPE), bisect offset (BSO), and lateral patellar displacement (LPD). Each patient had three MRIs: one with the knee resting in extension, one in voluntary quadriceps active hyperextension, and one in voluntary quadriceps active 30 degree flexion. Statistics were then calculated using Statistical Package for the Social Sciences (SPSS) (IBM corp). Tibial tubercle transfer distances required to achieve congruency intraoperatively correlated moderately (0.500-0.300) and were statistically significant (alpha .050) for passive extension MRI measurement of TT-TG (Pearson--0.403, alpha 0.010) and LPD (Pearson .362, alpha 0.022); voluntary quadriceps active hyperextension TT-TG (Pearson 0.487, alpha, 0.001); voluntary quadriceps active flexion TT-TG (Pearson .548, alpha< 0.001), LPE (Pearson .332, alpha 0.029), and LPD (Pearson 0.446 alpha .003). The hypothesis that voluntary quadriceps active hyperextension MRI LPE measurement best correlated with tibial tubercle transfer distance was incorrect. The data collected showed correlation and statistical significance for voluntary quadriceps active flexion LPE with required tibal tubercle transfer distance (Pearson 0.34, alpha 0.026). The MRI measurement that best correlated with tibial tubercle transfer distance was voluntary quadriceps active flexion measure of TT-TG (Pearson .556, alpha< 0.001).


PMID: 25328455

Other references

Hanes, M.V., 1964: Ectopic Pregnancy Following Total Hysterectomy. Report Of A Case. Obstetrics and Gynecology 23: 882-884

Yokoyama, M.; Wada, J., 1983: New pacers and electrodes. Rinsho Kyobu Geka 3(1): 60-66

Beshovski, V., 1976: Acartophthalmidae, Anthomyzidae, Aulacigastridae, Camilidae and Diastatidae - new Diptera - Brachycera for the Bulgarian fauna. Acta zool Bulg, 5: 93-97

Moskowitz, Ruth, B., 1981: Family style service: A better way. For schools without lunchrooms or kitchens, several methods have evolved to provide a lunch program, as in suburban New Jersey. The earliest efforts used frozen, preplated entrees on roll-in carts to be heated in convection ovens or mobile warming...

Bonke,R.; Meyer,C.; Stuber,E.; Fredriksson-Ahomaa,M., 2010: Detection of beta -lactamase A and B in human and porcine strains of Yersinia enterocolitica 4/O3 from Bavaria in Germany. <i>Yersinia</i> (<i>Y.</i>) <i>enterocolitica</i> 4/O:3 is one of the most important causes of food-borne yersiniosis in Germany. Pigs have been recognised as the main reservoir for <i>Y. enterocolitica<...

Saundby, R., 1899: An Inaugural Address on the Proper Objects and Necessary Limitations of Medical Education: Delivered at the Opening of the Winter Session of the Nottingham Medico-Chirurgical Society on October 4th, 1899. British Medical Journal 2(2023): 937-941

Munn, M.T.; Buchholz, A.B., 1948: The quality of seeds on sale in New York in 1947. During 1947, 3,567 samples of agric, flower, shrub, tree, and vegetable seeds purchased in the open markets of the State by inspectors of the Bureau of Plant Industry of the State Department of Agriculture and Markets were sent to the Expt. Statio...

Ferroni, A.; Guillemot, D.; Moumile, K.; Bernede, C.; L.B.urgeois, M.; Waernessyckle, S.; Descamps, P.; Sermet-Gaudelus, I.; Lenoir, Gérard.; Berche, P.; Taddei, Fçois., 2009: Effect of mutator P. aeruginosa on antibiotic resistance acquisition and respiratory function in cystic fibrosis. Cystic fibrosis patients suffer from recurrent bacterial infections that result in progressive deterioration of their respiratory function. Despite intensive antibiotic treatment, Pseudomonas aeruginosa is the main cause of such infections, with c...

Basora Macaya, M., 2015: Treatment of anemia in patients undergoing bariatric surgery. Iron deficiency in patients with morbid obesity can occur before bariatric surgery due to its inflammatory component and after surgery as the result of implementing the malabsorptive techniques. For patients with morbid obesity, micronutrient defi...

Giuffrida, M.; Hernández, I.; Chacín-Melean, J., 1996: Role of calcium in the regulation of oxoglutarate oxidation in the rabbit gastric mucosa. The stimulation of the oxyntic cell by gastric secretagogues is associated to the activation of oxidative metabolism. The mechanisms of this activation are not exactly known. In the present work, we investigated the possible direct effect of Ca2+...