Journal article
Case Report: Quantitative MRI of Tibial Tubercle Transfer During Active Quadriceps Contraction
Clinical orthopaedics and related research, Vol.469(1), pp.294-299
01/2011
DOI: 10.1007/s11999-010-1598-8
PMCID: PMC3008881
PMID: 20941650
Abstract
Background: The evaluation of distal transfer procedures relies primarily on qualitative clinical findings. Although quantitative MRI measurements provide an objective supplement to qualitative clinical findings, an association between qualitative clinical findings and quantitative patellofemoral indices has yet to be established.
Case description: A 21-year-old man presented with frequent episodes of patellar dislocation. Clinical and radiographic findings identified the patient as a candidate for realignment. MR images were obtained with the quadriceps contracted at 30° flexion and in full extension preoperatively and postoperatively. The procedure eliminated the clinical J-sign, defined as lateral movement of the patella over the lateral femoral condyle during active leg extension, which was confirmed quantitatively using established patellofemoral indices in conjunction with MRI.
Literature review: Movement of the patellofemoral joint is complex and dependent on many factors, including skeletal geometry, dynamic muscle action, and soft tissue restraints. Therefore, proper clinical and radiographic evaluation of patellar tracking requires observation during active quadriceps contraction. However, it is unclear whether there is any association between quantitative radiographic indices and qualitative clinical assessment during active quadriceps contraction.
Purposes and clinical relevance: We believe objective measurements are valuable in determining the radiographic assessment of patellar realignment procedures. Lateral patellar edge appears to quantify the clinical J-sign. The association between radiographic medialization of the patella and clinical improvement postoperatively in this patient warrants additional investigation in a larger group of patients with longer followup.
Details
- Title: Subtitle
- Case Report: Quantitative MRI of Tibial Tubercle Transfer During Active Quadriceps Contraction
- Creators
- Kyle Duchman - University of Iowa Carver College of Medicine, Iowa City, IA USAChloe Mellecker - University of Iowa Carver College of Medicine, Iowa City, IA USAAhmad Y El-Hattab - University of Iowa Carver College of Medicine, Iowa City, IA USAJohn P Albright - Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- Clinical orthopaedics and related research, Vol.469(1), pp.294-299
- DOI
- 10.1007/s11999-010-1598-8
- PMID
- 20941650
- PMCID
- PMC3008881
- NLM abbreviation
- Clin Orthop Relat Res
- ISSN
- 0009-921X
- eISSN
- 1528-1132
- Publisher
- Springer-Verlag; New York
- Language
- English
- Date published
- 01/2011
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040399202771
Metrics
34 Record Views