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ANORMAL PATELLA YÜKSEKLİĞİ İZOLE MENİSKÜS YIRTIKLARI İÇİN PREDİSPOZAN BİR FAKTÖR MÜ?

Yıl 2022, Cilt: 85 Sayı: 3, 326 - 331, 06.07.2022
https://doi.org/10.26650/IUITFD.1102322

Öz

Amaç: Patella yüksekliği ile birçok diz patolojisi arasındaki ilişki incelenmişken izole menisküs yırtıkları ile arasında ilişki olup olmadığı değerlendirilmemiştir. Çalışmamızın amacı diz biyomekaniği üzerinde önemli bir rolü olan patella yüksekliğinin izole medial veya lateral menisküs yırtığı için predispozan bir faktör olup olmadığını araştırmaktır.
Gereç ve Yöntem: Çalışmada 2018-2020 yılları arasında diz problemleri nedeni ile manyetik rezonans (MR) görüntülemesi yapılan 411 hasta retrospektif olarak incelendi. Yaş aralığı 18 ile 50 olan, izole medial veya izole lateral menisküs yırtığı olan hastalar çalışmaya dahil edildi. Menisküs lezyonu ve bağ yaralanması olmayan hastalar kontrol grubunu oluşturdu. Çalışmaya alınan 160 hastanın, 65’i izole medial menisküs, 30’u izole lateral menisküs ve 65’i kontrol grubu olarak üç gruba ayrıldı. Hastaların çekilen diz MR’larında patella yüksekliği İnsall-Salvati yöntemine göre ile iki ortopedi uzmanı tarafından bir ay ara ile iki kez ölçüldü.
Bulgular: Her üç grup arasında yaş ve cinsiyet dağılımı anlamlı farklılık göstermemiştir (p>0,05). Ortalama patellar tendon uzunluğu (p=0,059), patella uzunluğu (p=0,252) ve İnsall-Salvati oranları (p=0,810) incelendiğinde gruplar arasında anlamlı fark saptanmamıştır. Gruplardaki anormal patella yüksekliği oranları karşılaştırıldığında medial menisküs ve kontrol grubunda sonuçlar benzer iken (%12,4-%13,9) lateral menisküs grubunda anormal patella yüksekliğinin (%33,4) özellikle de patella bajanın daha sık görüldüğü gözlenmiştir. Ancak istatistiksel olarak anlamlı bir fark bulunmamıştır. Her iki gözlemcinin ölçümleri incelendiğinde ise gözlemciler arası ve gözlemciler içi anlamlı güçlü korelasyon gözlenmiştir (p=0,000).
Sonuç: Çalışmamızda ortalama İnsall-Salvati oranları gruplar arasında benzer bulunmakla beraber izole lateral menisküs grubunda anormal patella yüksekliği özellikle de patella baja daha sık görülmüştür. Anormal patella yüksekliği izole lateral menisküs yırtığı için predispozan bir faktör olabilir.

Kaynakça

  • 1. Gobbi RG, Videira LD, Dos Santos AA, Saruhashi MB, Lucarini BR, Fernandes RJR, et al. Anatomical Risk Factors for Anterior Cruciate Ligament Injury Are Not Important As Patellar Instability Risk Factors in Patients with Acute Knee Injury. J Knee Surg 2020. Online ahead of print. [CrossRef] google scholar
  • 2. Snoeker BA, Bakker EW, Kegel CA, Lucas C. Risk factors for meniscal tears: a systematic review including meta-analysis. J Orthop Sports Phys Ther 2013;43(6):352-67. [CrossRef] google scholar
  • 3. Draijer LW, Belo JN, Berg HF, Geijer RM, Goudswaard AN. [Summary of the practice guideline ‘Traumatic knee problems’ (first revision) from the Dutch College of General Practitioners]. Ned Tijdschr Geneeskd 2010;154:A2225. google scholar
  • 4. Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008; 359(11):1108-15. [CrossRef] google scholar
  • 5. Gaillard R, Magnussen R, Batailler C, Neyret P, Lustig S, Servien E. Anatomic risk factor for meniscal lesion in association with ACL rupture. J Orthop Surg Res 2019;14(1):242. [CrossRef] google scholar
  • 6. Vampertzis T, Barmpagianni C, Nitis G, Papastergiou S. A study of the possible effect of abnormal patella height on meniscal tears. J Orthop 2020;22:170-2. [CrossRef] google scholar
  • 7. Li W, Liang J, Zeng F, Lin B, Liu C, Huang S, et al. Anatomic characteristics of the knee influence the risk of suffering an isolated meniscal injury and the risk factors differ between women and men. Knee Surg Sports Traumatol Arthrosc 2021;29(11):3751-62. [CrossRef] google scholar
  • 8. Lin CF, Wu JJ, Chen TS, Huang TF. Comparison of the Insall-Salvati ratio of the patella in patients with and without an ACL tear. Knee Surg Sports Traumatol Arthrosc 2005;13(1):8-11. [CrossRef] google scholar
  • 9. Lu W, Yang J, Chen S, Zhu Y, Zhu C. Abnormal Patella Height Based on Insall-Salvati Ratio and its Correlation with Patellar Cartilage Lesions: An Extremity-Dedicated Low-Field Magnetic Resonance Imaging Analysis of 1703 Chinese Cases. Scand J Surg 2016;105(3):197-203. [CrossRef] google scholar
  • 10. Balcarek P, Oberthur S, Hopfensitz S, Frosch S, Walde TA, Wachowski MM, et al. Which patellae are likely to redislocate? Knee Surg Sports Traumatol Arthrosc 2014;22(10):2308-14. [CrossRef] google scholar
  • 11. Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971;101(1):101-4. [CrossRef] google scholar
  • 12. Okazaki Y, Furumatsu T, Kodama Y, Kamatsuki Y, Okazaki Y, Hiranaka T, et al. Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc 2021;29(1):44-50. [CrossRef] google scholar
  • 13. Caton J. [Method of measuring the height of the patella]. Acta Orthop Belg 1989;55(3):385-6. google scholar
  • 14. Grelsamer RP, Meadows S. The modified Insall-Salvati ratio for assessment of patellar height. Clin Orthop Relat Res 1992;(282):170-6. [CrossRef] google scholar
  • 15. Biedert RM, Albrecht S. The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 2006;14(8):707-12. [CrossRef] google scholar
  • 16. Blackburne JS, Peel TE. A new method of measuring patellar height. J Bone Joint Surg Br 1977;59(2):241-2. [CrossRef] google scholar
  • 17. Barnett AJ, Prentice M, Mandalia V, Wakeley CJ, Eldridge JD. Patellar height measurement in trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 2009;17(12):1412-5. [CrossRef] google scholar
  • 18. Verhulst FV, van Sambeeck JDP, Olthuis GS, van der Ree J, Koeter S. Patellar height measurements: Insall-Salvati ratio is most reliable method. Knee Surg Sports Traumatol Arthrosc 2020;28(3):869-75. [CrossRef] google scholar
  • 19. Lee PP, Chalian M, Carrino JA, Eng J, Chhabra A. Multimodality correlations of patellar height measurement on X-ray, CT, and MRI. Skeletal Radiol 2012;41(10):1309-14. [CrossRef] google scholar
  • 20. Baker BE, Peckham AC, Pupparo F, Sanborn JC. Review of meniscal injury and associated sports. Am J Sports Med 1985;13(1):1-4. [CrossRef] google scholar

IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?

Yıl 2022, Cilt: 85 Sayı: 3, 326 - 331, 06.07.2022
https://doi.org/10.26650/IUITFD.1102322

Öz

Objective: The relationship between patellar height and knee pathologies has been assessed in the literature. However, the relationship with isolated meniscal tears has not been evaluated. This study aims to evaluate whether or not patellar height is a predisposing factor for isolated medial or lateral meniscal tear.
Material and Methods: The consecutive 411 patients who had magnetic resonance imaging between 2018-2020 were evaluated retrospectively. The patients between 18 and 50 years of age with isolated medial or lateral meniscal tear were included. The patients without any meniscal tear or ligament injury formed the control group. The 160 patients included in the study were divided into three groups: 65 medial meniscus, 30 lateral meniscus, and 65 control group. Patellar height was measured with the Insall-Salvati method by two orthopedic surgeons twice, with an interval of one month.
Results: All of the groups were similar in terms of age and gender (p>0,05). Patellar length (p=0.252), patellar tendon length (p=0.059), and Insall-Salvati ratios (p=0.810) of all groups did not show any significant difference. The abnormal patellar height rates were similar in the medial meniscus and control groups (12.4%-13.9%), while abnormal patella height (33.4%), especially patella baja, was observed more frequently in the lateral meniscus group. However, no statistically significant difference was found. A significant strong correlation was observed between and within the observers’ measurements (p=0.000).
Conclusion: Abnormal patella height, especially patella baja, was observed more frequently in the isolated lateral meniscus group. Abnormal patellar height could be a predisposing factor for isolated lateral meniscal tear.

Kaynakça

  • 1. Gobbi RG, Videira LD, Dos Santos AA, Saruhashi MB, Lucarini BR, Fernandes RJR, et al. Anatomical Risk Factors for Anterior Cruciate Ligament Injury Are Not Important As Patellar Instability Risk Factors in Patients with Acute Knee Injury. J Knee Surg 2020. Online ahead of print. [CrossRef] google scholar
  • 2. Snoeker BA, Bakker EW, Kegel CA, Lucas C. Risk factors for meniscal tears: a systematic review including meta-analysis. J Orthop Sports Phys Ther 2013;43(6):352-67. [CrossRef] google scholar
  • 3. Draijer LW, Belo JN, Berg HF, Geijer RM, Goudswaard AN. [Summary of the practice guideline ‘Traumatic knee problems’ (first revision) from the Dutch College of General Practitioners]. Ned Tijdschr Geneeskd 2010;154:A2225. google scholar
  • 4. Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008; 359(11):1108-15. [CrossRef] google scholar
  • 5. Gaillard R, Magnussen R, Batailler C, Neyret P, Lustig S, Servien E. Anatomic risk factor for meniscal lesion in association with ACL rupture. J Orthop Surg Res 2019;14(1):242. [CrossRef] google scholar
  • 6. Vampertzis T, Barmpagianni C, Nitis G, Papastergiou S. A study of the possible effect of abnormal patella height on meniscal tears. J Orthop 2020;22:170-2. [CrossRef] google scholar
  • 7. Li W, Liang J, Zeng F, Lin B, Liu C, Huang S, et al. Anatomic characteristics of the knee influence the risk of suffering an isolated meniscal injury and the risk factors differ between women and men. Knee Surg Sports Traumatol Arthrosc 2021;29(11):3751-62. [CrossRef] google scholar
  • 8. Lin CF, Wu JJ, Chen TS, Huang TF. Comparison of the Insall-Salvati ratio of the patella in patients with and without an ACL tear. Knee Surg Sports Traumatol Arthrosc 2005;13(1):8-11. [CrossRef] google scholar
  • 9. Lu W, Yang J, Chen S, Zhu Y, Zhu C. Abnormal Patella Height Based on Insall-Salvati Ratio and its Correlation with Patellar Cartilage Lesions: An Extremity-Dedicated Low-Field Magnetic Resonance Imaging Analysis of 1703 Chinese Cases. Scand J Surg 2016;105(3):197-203. [CrossRef] google scholar
  • 10. Balcarek P, Oberthur S, Hopfensitz S, Frosch S, Walde TA, Wachowski MM, et al. Which patellae are likely to redislocate? Knee Surg Sports Traumatol Arthrosc 2014;22(10):2308-14. [CrossRef] google scholar
  • 11. Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971;101(1):101-4. [CrossRef] google scholar
  • 12. Okazaki Y, Furumatsu T, Kodama Y, Kamatsuki Y, Okazaki Y, Hiranaka T, et al. Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc 2021;29(1):44-50. [CrossRef] google scholar
  • 13. Caton J. [Method of measuring the height of the patella]. Acta Orthop Belg 1989;55(3):385-6. google scholar
  • 14. Grelsamer RP, Meadows S. The modified Insall-Salvati ratio for assessment of patellar height. Clin Orthop Relat Res 1992;(282):170-6. [CrossRef] google scholar
  • 15. Biedert RM, Albrecht S. The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 2006;14(8):707-12. [CrossRef] google scholar
  • 16. Blackburne JS, Peel TE. A new method of measuring patellar height. J Bone Joint Surg Br 1977;59(2):241-2. [CrossRef] google scholar
  • 17. Barnett AJ, Prentice M, Mandalia V, Wakeley CJ, Eldridge JD. Patellar height measurement in trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 2009;17(12):1412-5. [CrossRef] google scholar
  • 18. Verhulst FV, van Sambeeck JDP, Olthuis GS, van der Ree J, Koeter S. Patellar height measurements: Insall-Salvati ratio is most reliable method. Knee Surg Sports Traumatol Arthrosc 2020;28(3):869-75. [CrossRef] google scholar
  • 19. Lee PP, Chalian M, Carrino JA, Eng J, Chhabra A. Multimodality correlations of patellar height measurement on X-ray, CT, and MRI. Skeletal Radiol 2012;41(10):1309-14. [CrossRef] google scholar
  • 20. Baker BE, Peckham AC, Pupparo F, Sanborn JC. Review of meniscal injury and associated sports. Am J Sports Med 1985;13(1):1-4. [CrossRef] google scholar
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ARAŞTIRMA
Yazarlar

Onur Tunalı 0000-0002-7808-9426

Natig Valiyev Bu kişi benim 0000-0001-6784-4636

Kayahan Karaytug 0000-0002-8138-8232

Yayımlanma Tarihi 6 Temmuz 2022
Gönderilme Tarihi 13 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 85 Sayı: 3

Kaynak Göster

APA Tunalı, O., Valiyev, N., & Karaytug, K. (2022). IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?. Journal of Istanbul Faculty of Medicine, 85(3), 326-331. https://doi.org/10.26650/IUITFD.1102322
AMA Tunalı O, Valiyev N, Karaytug K. IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?. İst Tıp Fak Derg. Temmuz 2022;85(3):326-331. doi:10.26650/IUITFD.1102322
Chicago Tunalı, Onur, Natig Valiyev, ve Kayahan Karaytug. “IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?”. Journal of Istanbul Faculty of Medicine 85, sy. 3 (Temmuz 2022): 326-31. https://doi.org/10.26650/IUITFD.1102322.
EndNote Tunalı O, Valiyev N, Karaytug K (01 Temmuz 2022) IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?. Journal of Istanbul Faculty of Medicine 85 3 326–331.
IEEE O. Tunalı, N. Valiyev, ve K. Karaytug, “IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?”, İst Tıp Fak Derg, c. 85, sy. 3, ss. 326–331, 2022, doi: 10.26650/IUITFD.1102322.
ISNAD Tunalı, Onur vd. “IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?”. Journal of Istanbul Faculty of Medicine 85/3 (Temmuz 2022), 326-331. https://doi.org/10.26650/IUITFD.1102322.
JAMA Tunalı O, Valiyev N, Karaytug K. IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?. İst Tıp Fak Derg. 2022;85:326–331.
MLA Tunalı, Onur vd. “IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?”. Journal of Istanbul Faculty of Medicine, c. 85, sy. 3, 2022, ss. 326-31, doi:10.26650/IUITFD.1102322.
Vancouver Tunalı O, Valiyev N, Karaytug K. IS ABNORMAL PATELLA HEIGHT A PREDISPOSING FACTOR FOR ISOLATED MENISCAL TEARS?. İst Tıp Fak Derg. 2022;85(3):326-31.

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