Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CT
Abstract Objectives To propose a reliable and standard 3D assessment method to analyze the effect of weight-bearing (WB) status on the location of patella and clarify the diagnostic performance of 3D parameters for recurrent patellar dislocation (RPD) in WB and non-weight-bearing (NWB) conditions. M...
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SpringerOpen
2025-01-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-024-01883-6 |
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| author | Yurou Chen Fan Yu Fanzhuang Rong Furong Lv Fajin Lv Jia Li |
| author_facet | Yurou Chen Fan Yu Fanzhuang Rong Furong Lv Fajin Lv Jia Li |
| author_sort | Yurou Chen |
| collection | DOAJ |
| description | Abstract Objectives To propose a reliable and standard 3D assessment method to analyze the effect of weight-bearing (WB) status on the location of patella and clarify the diagnostic performance of 3D parameters for recurrent patellar dislocation (RPD) in WB and non-weight-bearing (NWB) conditions. Methods Sixty-five knees of RPD patients and 99 knees of controls were included. Eight landmarks, two lines and a coordinate system were defined on 3D bone models of knees based on weight-bearing CT and non-weight-bearing CT. The shift and tilt of patella in three orthogonal axes (X shift, Y shift, Z shift, X tilt, Y tilt, Z tilt) were evaluated. Results X shift and Y shift were significantly higher, Z shift, X tilt and Y tilt were significantly lower in WB condition than NWB condition (p < 0.001, p < 0.001, p = 0.001, p = 0.002, p = 0.010). In both WB and NWB conditions, X shift, Y shift and Z tilt were significantly higher, and X tilt was significantly lower in the RPD group than the control group (WB/NWB: p < 0.001/p = 0.002, p < 0.001/p = 0.001, p < 0.001/p < 0.001, p < 0.001/p = 0.009). In WB condition, Z shift and Y tilt were significantly higher in the RPD group than the control group (p = 0.011, p < 0.001). Z tilt had the best diagnostic performance for RPD in both WB and NWB conditions, with AUC of 0.887 (95% CI: 0.828, 0.946) and 0.885 (95% CI: 0.822, 0.947), respectively. Conclusions The 3D measurement method reliably and comprehensively reflected the relative spatial position relationship of the patellofemoral joint. It can be applied to the 3D preoperative planning of patellofemoral procedures. In addition, patellofemoral evaluation under the WB condition was essential to detect subtle underlying risk factors for RPD, with axial lateral patellar tilt being the best predictor. Critical relevance statement This 3D measurement method under weight-bearing conditions contributes to comprehensively describing the relative spatial position of the patellofemoral joint in a standardized way and can be applied to preoperative evaluation for recurrent patellar dislocation. Key Points Patellofemoral alignment is a 3D problem, and the accuracy of 2D parameters has been questioned. 3D measurement was reliable and comprehensively reflected relative spatial relationships of the patellofemoral joint. 3D measurements under weight-bearing condition help preoperative evaluation for RPD. Graphical Abstract |
| format | Article |
| id | doaj-art-73fc74fda9764393a58ebbb5c203f8f2 |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
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| series | Insights into Imaging |
| spelling | doaj-art-73fc74fda9764393a58ebbb5c203f8f22025-01-05T12:32:37ZengSpringerOpenInsights into Imaging1869-41012025-01-0116111010.1186/s13244-024-01883-6Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CTYurou Chen0Fan Yu1Fanzhuang Rong2Furong Lv3Fajin Lv4Jia Li5Department of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityShenzhen Angell Technology Co. Ltd.Department of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Objectives To propose a reliable and standard 3D assessment method to analyze the effect of weight-bearing (WB) status on the location of patella and clarify the diagnostic performance of 3D parameters for recurrent patellar dislocation (RPD) in WB and non-weight-bearing (NWB) conditions. Methods Sixty-five knees of RPD patients and 99 knees of controls were included. Eight landmarks, two lines and a coordinate system were defined on 3D bone models of knees based on weight-bearing CT and non-weight-bearing CT. The shift and tilt of patella in three orthogonal axes (X shift, Y shift, Z shift, X tilt, Y tilt, Z tilt) were evaluated. Results X shift and Y shift were significantly higher, Z shift, X tilt and Y tilt were significantly lower in WB condition than NWB condition (p < 0.001, p < 0.001, p = 0.001, p = 0.002, p = 0.010). In both WB and NWB conditions, X shift, Y shift and Z tilt were significantly higher, and X tilt was significantly lower in the RPD group than the control group (WB/NWB: p < 0.001/p = 0.002, p < 0.001/p = 0.001, p < 0.001/p < 0.001, p < 0.001/p = 0.009). In WB condition, Z shift and Y tilt were significantly higher in the RPD group than the control group (p = 0.011, p < 0.001). Z tilt had the best diagnostic performance for RPD in both WB and NWB conditions, with AUC of 0.887 (95% CI: 0.828, 0.946) and 0.885 (95% CI: 0.822, 0.947), respectively. Conclusions The 3D measurement method reliably and comprehensively reflected the relative spatial position relationship of the patellofemoral joint. It can be applied to the 3D preoperative planning of patellofemoral procedures. In addition, patellofemoral evaluation under the WB condition was essential to detect subtle underlying risk factors for RPD, with axial lateral patellar tilt being the best predictor. Critical relevance statement This 3D measurement method under weight-bearing conditions contributes to comprehensively describing the relative spatial position of the patellofemoral joint in a standardized way and can be applied to preoperative evaluation for recurrent patellar dislocation. Key Points Patellofemoral alignment is a 3D problem, and the accuracy of 2D parameters has been questioned. 3D measurement was reliable and comprehensively reflected relative spatial relationships of the patellofemoral joint. 3D measurements under weight-bearing condition help preoperative evaluation for RPD. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01883-6Three-dimensional measurementWeight-bearingPatellofemoral alignmentRecurrent patellar dislocationPreoperative planning |
| spellingShingle | Yurou Chen Fan Yu Fanzhuang Rong Furong Lv Fajin Lv Jia Li Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CT Insights into Imaging Three-dimensional measurement Weight-bearing Patellofemoral alignment Recurrent patellar dislocation Preoperative planning |
| title | Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CT |
| title_full | Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CT |
| title_fullStr | Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CT |
| title_full_unstemmed | Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CT |
| title_short | Analysis of spatial patellofemoral alignment using novel three-dimensional measurements based on weight-bearing cone-beam CT |
| title_sort | analysis of spatial patellofemoral alignment using novel three dimensional measurements based on weight bearing cone beam ct |
| topic | Three-dimensional measurement Weight-bearing Patellofemoral alignment Recurrent patellar dislocation Preoperative planning |
| url | https://doi.org/10.1186/s13244-024-01883-6 |
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