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Introduction: Morphometric analysis of the patella has beenreported to be important in forensic identification, implantdesign and in some reconstructive procedures of the knee.Longevity and success of knee replacement depends also inproper implant dimensions. The size and shape of articularsurface of patella, width, height, thickness and width of medialand lateral facets of patella are the important parameters thatcan determine the stability of patellofemoral joint and implantdesign. This study aimed at the morphometric and comparativeanalysis of patella in eastern part of India.Material and Methods: 89 dry bones were collected from thestudents and the departmental bone bank. Measurements weretaken by using Vernier Callipers.Results: Bony features and abnormalities if any were noted.Classification of patella, based on the dimensions of thearticular facets and dimensions of the patella and articularfacets were also noted.Conclusion: This type of morphometric study on patella mayhelp in implant designing and forensic measurements
ABSTRACT
Objective To study the correlation of patellar stability with age ,knee Kellgren-Lawrence grading and patellar Wiberg typing of adults with Kaschin-Beck disease (KBD) .Methods Through cross-sectional study , we asked 143 adult patients with KBD from several villages in Gansu Province to receive digital radiographic x-ray (DR) which included lateral slice of knee joint and axis slice of patellar .Meanwhile ,each patient had to undergo patellar stability measurement on the DR film which included some indexes such as Insall index , lateral patellofemoral angle ,sulcus angle ,congruence angle ,lateral migrating ratio of patella ,and patellofemoral index . Then ,all the participants were divided into four groups based on the patella Wiberg typing and three groups based on KBD clinical grading .Last ,we analyzed the correlation of patellar stability with patellar Wiberg typing ,clinical KBD grading ,and Kellgren-Lawrence grading of the patients by Spearman test .Results ① By ANOVA test on the patella Wiberg typing ,lateral patellofemoral angle decreased with increased level of patella Wiberg typing ,but congruence angle ,lateral migrating ratio of patella ,and patellofemoral index were increased with increased level of patella Wiberg typing . P values of the six indexes were all <0 .05 ,which indicated that these differences between groups were significant .By ANOVA test on the KBD clinical grading ,lateral patellofemoral angle decreased with increased level of KBD clinical grading ,but congruence angle ,lateral migrating ratio of patella ,sulcus angle ,and patellofemoral index increased with increased level of KBD clinical grading .Besides that P value of Insall index was>0 .05 , P value of the other five indexes were all <0 .05 ,which indicated these differences between groups were significant .② Spearman test :a strong correlation lay between Wiberg patellar typing and other indexes including age ,lateral patellofemoral angle ,congruence angle ,lateral migrating ratio of patella ,and patellofemoral index ( R=0 .684 ,0 .752 ,0 .582 ,0 .533 ,0 .735 , P< 0 .05) .However ,there was no correlation between Wiberg patellar typing and K-L photographical grading (R=0 .030 ,P>0 .05) .K-L grading was strongly correlated with age (R=0 .782 , P< 0 .05 ) , weakly correlated with lateral migrating ratio of patella ( R = 0 .104 , P> 0 .05 ) , but not correlated with the others ( R < 0 .1 , P> 0 .05 ) . Age was strongly correlated with K-L grading and lateral patellofemoral angle (R=0 .782 ,0 .506 ,P<0 .05) ,moderately correlated with congruence angle ,lateral migrating ratio of patella ,and patellofemoral index (R=0 .403 ,0 .361 ,0 .475 , P< 0 .05) ,but not correlated with Wiberg typing ,sulcus angle ,or Insall index ( R=0 .024 ,0 .074 ,0 .053 , P>0 .05) .Conclusion Patellar Wiberg typing is the key factor which influences latellar stability ;age has a limited influence ,while K-L grading does not affect patellar stability .
ABSTRACT
Patellofemoral arthritis is a clinical common type of knee osteoarthritis distinguished by its pain and anatomical position. The stability of patella is crucial to the stability of the patellofemoral joint and is related to the occurrence and development of osteoarthritis. Patella stability depends on the structural geometry of patellofemoral condyle, the static mechanics of the surrounding joint capsule, tendon, fascia, ligament and patellar ligament and the dynamic mechanics of the quadriceps. Therefore, manipulation therapy should be based on the considerations on the stability of the patella as well as TCM theory. Starting from maintaining the balance of the dynamic and static mechanical system and focusing on the restoration of the stability of patella, the ultimate goal of the treatment is to restore the stability of patellofemoral joint. The main aspects of manipulation treatment strategy include the balancing of dynamic and static mechanical system, the idea of holism treatment, differentiation treatment based on tendons injury identification, fundamental principle of softening tendons, cooperation between doctors and patients, and combination of therapy and convalesce.