Patellar shape can be a predisposing factor in patellar instability

Panni, Alfredo Schiavone, Cerciello, Simone, Maffulli, Nicola, Di Cesare, Mariachiara, Servien, Elvire and Neyret, Philippe (2012) Patellar shape can be a predisposing factor in patellar instability. Knee Surgery, Sports Traumatology, Arthroscopy, 19 (4). pp. 663-670. ISSN 0942-2056

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Purpose: Predisposing factors to objective patellar instability include trochlear dysplasia, patella alta, patellar tilt and elevated tibial tuberosity-femoral groove distance. The shape of the patella is classically not considered a predisposing factor. Anomalies of dynamic and static factors, including excessive patellar height, tibial tubercle lateralisation or trochlear dysplasia, may influence the development of the patella. Methods: One hundred and five patients (140 knees) with objective patellar instability were retrospectively reviewed to identify a possible association between the above-mentioned predisposing factors and patellar shape. All patients were evaluated with static and dynamic CT scans, and plain lateral and antero-posterior radiographs, and skyline patellar views. Results: Evidence of a significant association emerged between patellar shape and patellar tilt in static (rs = 0.20, P = 0.019) or dynamic conditions (rs = 0.18, P = 0.031) and a significant association between Wiberg patellar shape type C and trochlear dysplasia grade 3 (¿2 = 4.5, P = 0.035). Also, we found a significant association between trochlear dysplasia stage 3 and tibial tuberosity-trochlear groove (TT-TG) and patellar tilt relaxed (P < 0.01 and P < 0.05, respectively). There is an association between patellar shape and patellar tilt. Conclusion: Increased lateral stresses may produce a Wiberg type C patella, with a hypoplastic medial facet and a more developed lateral facet. Unbalance between dynamic medial and lateral stabilisers may act as an additional factor. A rehabilitation program aiming to reduce this unbalance may decrease the incidence of type C patella in young patients. © 2010 Springer-Verlag

Item Type: Article
Schools and Departments: School of Education and Social Work > Education
Depositing User: Mariachiara DiCesare
Date Deposited: 15 Feb 2013 14:25
Last Modified: 15 Feb 2013 14:25
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