University of Twente Student Theses
Validating and developing measurement techniques to assess patellofemoral instability using dynamic Computed Tomography.
Dijk, H.H. van (2023) Validating and developing measurement techniques to assess patellofemoral instability using dynamic Computed Tomography.
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| Abstract: | Introduction : A prevalence of 6 to 77 per 100.000 is estimated for acute traumatic patellar dislocations, mostly affecting adolescents. When some predisposing factors, or anatomical variations, are present, there is an increased risk for patellar luxation. Some important predisposing factors are patella alta, trochlear dysplasia and an increased tibial tuberosity-trochlear groove (TT-TG) distance. The use of dynamic imaging, such as four dimensional computed tomography (4D CT) could help in understanding the movement of the knee. This research was conducted to obtain more knowledge regarding the current patella alta measurements, the Insall Salvati and Caton Deschamps index (CDI), and the relationship between the movement of the patella in relation to the trochlear groove. Methods: Two databases, one of healthy volunteers and one of patients with patellofemoral instability (PFI) were used for this research. To assess the current patella alta measurement simulated X-rays were created on which the indices were measured. The novel method looked at the patella lateralization in relation to the trochlear groove by determining both condyles, the trochlear groove and the patellar projection point. The distance between the patellar projection point and trochlear groove was determined for further statistical analysis. Results: Regarding the patella alta measurements, not many statistical differences were found. For both indices a difference was found for the effect of muscle tension. For the CDI a change of tibiofemoral flection angle and a adduction of 5° was found to be statistically different. With regard to the patellar lateralization, a statistical difference was found between the healthy volunteers and patients with PFI throughout the first half of the trochlear groove. When looking at individual patients some showed an aberrant tracking but some showed a normal tracking as well. Conclusion: Based on this research it can be concluded that both the Insall Salvati and the Caton Deschamps index are robust measurement methods for patella alta. Besides, the distance between the patellar projection point and trochlear groove showed increased lateralization in patients with PFI. Future research should focus on optimizing and elaborating this workflow to include other predisposing factors. This will hopefully lead towards a patient specific guideline for the diagnosis and treatment of patients with PFI. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/94903 |
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