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Analysis of Lower Extremity Alignment (LEA) in Children with Recurrent Patellar Dislocation by EOS System

Overview
Journal Front Pediatr
Specialty Pediatrics
Date 2023 Nov 13
PMID 37954430
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Abstract

Objectives: Recurrent patellar dislocation (RPD) greatly affects active young individuals, necessitating the identification of risk factors for a better understanding of its cause. Previous research has connected RPD to lower limb alignment (LEA) abnormalities, such as increased femoral anteversion, tibial external rotation, knee valgus, and flexion. This study aims to use EOS technology to detect RPD-related LEA anomalies, enabling three-dimensional assessment under load conditions.

Methods: A total of 100 limbs (50 in the RPD group, 50 in the control group) were retrospectively analyzed. In the RPD group, we included limbs with recurrent patellar dislocation, characterized by dislocations occurs at least two times, while healthy limbs served as the control group. We used EOS technology, including 2D and 3D imaging, to measure and compare the following parameters between the two groups in a standing position: Femoral neck shaft angle (NSA), Mechanical femoral tibial angle (MFTA), Mechanical lateral distal femoral angle (mLDFA), Medial proximal tibial angle (MPTA), Anatomical femoral anteversion (AFA), External tibial torsion (ETT), and Femorotibial rotation (FTR).

Results: The significant differences between the two groups were shown in NSA 3/2D, MFTA 3/2D, mLDFA 3/2D, MPTA 3D, AFA, FTR. No significant difference was shown in MPTA 2D, ETT between the RPD group and the control group. Further binary logistic regression analysis. Further binary logistic regression analysis was conducted on the risk factors affecting RPD mentioned above. and found four risk factors for binary logistic regression analysis: mLDFA (3D), AFA, NSA(3D), and FTR.

Conclusions: EOS imaging identified abnormal LEA parameters, including NSA, MFTA, mLDFA, MPTA, AFA, and FTR, as risk factors for RPD. Children with these risk factors should receive moderate knee joint protection.

References
1.
Zhang Z, Zhang H, Song G, Wang X, Zhang J, Zheng T . A High-Grade J Sign Is More Likely to Yield Higher Postoperative Patellar Laxity and Residual Maltracking in Patients With Recurrent Patellar Dislocation Treated With Derotational Distal Femoral Osteotomy. Am J Sports Med. 2019; 48(1):117-127. DOI: 10.1177/0363546519884669. View

2.
Kim T, Sobti A, Lee S, Lee J, Oh K . The effects of weight-bearing conditions on patellofemoral indices in individuals without and with patellofemoral pain syndrome. Skeletal Radiol. 2013; 43(2):157-64. DOI: 10.1007/s00256-013-1756-7. View

3.
Kearney S, Mosca V . Selective hemiepiphyseodesis for patellar instability with associated genu valgum. J Orthop. 2015; 12(1):17-22. PMC: 4354475. DOI: 10.1016/j.jor.2015.01.005. View

4.
Chen C, Min L, Sun M, Weng W, Wang W . Abnormal femur rotation in patients with recurrent patellar dislocation: A study on upright standing three-dimensionally reconstructed EOS images. Knee. 2021; 32:131-139. DOI: 10.1016/j.knee.2021.08.011. View

5.
Elias D, White L . Imaging of patellofemoral disorders. Clin Radiol. 2004; 59(7):543-57. DOI: 10.1016/j.crad.2004.01.004. View