The patho-anatomy of patellofemoral subluxation

A. P. Monk, H. A. Doll, C. L. M. H. Gibbons, S. Ostlere, D. J. Beard, H. S. Gill, D. W. Murray

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Patella subluxation assessed on dynamic MRI has previously been shown to be associated with anterior knee pain. In this MRI study of 60 patients we investigated the relationship between subluxation and multiple bony, cartilaginous and soft-tissue factors that might predispose to subluxation using discriminant function analysis. Patella engagement (% of patella cartilage overlapping with trochlea cartilage) had the strongest relationship with subluxation. Patellae with > 30% engagement tended not to sublux; those with < 30% tended to sublux. Other factors that were associated with subluxation included the tibial tubercle-trochlea notch distance, vastus medialis obliquus distance from patella, patella alta, and the bony and cartilaginous sulcus angles in the superior part of the trochlea. No relationship was found between subluxation and sulcus angles for cartilage and bone in the middle and lower part of the trochlea, cartilage thicknesses and Wiberg classification of the patella. This study indicates that patella engagement is a key factor associated with patellar subluxation. This suggests that in patients with anterior knee pain with subluxation, resistant to conservative management, surgery directed towards improving patella engagement should be considered. A clinical trial is necessary to test this hypothesis.
Original languageEnglish
Pages (from-to)1341-1347
Number of pages7
JournalJournal of Bone and Joint Surgery - British Volume
Volume93 B
Issue number10
DOIs
Publication statusPublished - Oct 2011

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Patella
Anatomy
Cartilage
Knee
Pain
Quadriceps Muscle
Thromboplastin
Discriminant Analysis
Clinical Trials
Bone and Bones

Cite this

Monk, A. P., Doll, H. A., Gibbons, C. L. M. H., Ostlere, S., Beard, D. J., Gill, H. S., & Murray, D. W. (2011). The patho-anatomy of patellofemoral subluxation. Journal of Bone and Joint Surgery - British Volume, 93 B(10), 1341-1347. https://doi.org/10.1302/0301-620X.93B10.27205

The patho-anatomy of patellofemoral subluxation. / Monk, A. P.; Doll, H. A.; Gibbons, C. L. M. H.; Ostlere, S.; Beard, D. J.; Gill, H. S.; Murray, D. W.

In: Journal of Bone and Joint Surgery - British Volume, Vol. 93 B, No. 10, 10.2011, p. 1341-1347.

Research output: Contribution to journalArticle

Monk, AP, Doll, HA, Gibbons, CLMH, Ostlere, S, Beard, DJ, Gill, HS & Murray, DW 2011, 'The patho-anatomy of patellofemoral subluxation', Journal of Bone and Joint Surgery - British Volume, vol. 93 B, no. 10, pp. 1341-1347. https://doi.org/10.1302/0301-620X.93B10.27205
Monk, A. P. ; Doll, H. A. ; Gibbons, C. L. M. H. ; Ostlere, S. ; Beard, D. J. ; Gill, H. S. ; Murray, D. W. / The patho-anatomy of patellofemoral subluxation. In: Journal of Bone and Joint Surgery - British Volume. 2011 ; Vol. 93 B, No. 10. pp. 1341-1347.
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