Skip to main content
Erschienen in: International Orthopaedics 3/2016

01.03.2016 | Original Paper

The reliability of four widely used patellar height ratios

verfasst von: Dennis van Duijvenbode, Michel Stavenuiter, Bart Burger, Cees van Dijke, Jacco Spermon, Marco Hoozemans

Erschienen in: International Orthopaedics | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The objective of this study was to evaluate the inter-observer reliability and the intra-observer reliability of four patellar height ratios: Insall-Salvati (IS), modified Insall-Salvati (MIS), Blackburne-Peel (BP) and Caton-Deschamps (CD).

Methods

The patellar height ratios were assessed by four independent examiners using weight-bearing lateral knee radiographs in 30° flexion. Intra-class correlation coefficients and Fleiss’ kappa’s were determined.

Results

The inter-observer reliability was excellent for the IS and moderate for the other ratios. When the ratio values were categorized, the inter-observer reliability was strong for the IS, moderate for the MIS and BP, and poor for the CD. The intra-observer reliability was excellent for the IS, MIS and CD, and strong for the BP. When the ratio values were categorized, the intra-observer reliability was strong for the IS and MIS, and moderate for the other ratios.

Conclusion

Although the IS showed best reliability, we advise to use the MIS as it showed the second best reliability but is, according to the literature, associated with better validity.
Literatur
1.
Zurück zum Zitat AL-Sayyad MJ, Cameron JC (2002) Functional outcome after tibial tubercle transfer for the painful patella alta. Clin Orthop Relat Res 396:152–162CrossRefPubMed AL-Sayyad MJ, Cameron JC (2002) Functional outcome after tibial tubercle transfer for the painful patella alta. Clin Orthop Relat Res 396:152–162CrossRefPubMed
2.
Zurück zum Zitat Monk AP, Doll HA, Gibbons CL, Ostlere S, Beard DJ, Gill HS, Murray DW (2011) The patho-anatomy of patellofemoral subluxation. J Bone Joint Surg (Br) 93(10):1341–1347CrossRef Monk AP, Doll HA, Gibbons CL, Ostlere S, Beard DJ, Gill HS, Murray DW (2011) The patho-anatomy of patellofemoral subluxation. J Bone Joint Surg (Br) 93(10):1341–1347CrossRef
3.
Zurück zum Zitat Neyret P, Robinson AH, Le CB, Lapra C, Chambat P (2002) Patellar tendon length--the factor in patellar instability? Knee 9(1):3–6CrossRefPubMed Neyret P, Robinson AH, Le CB, Lapra C, Chambat P (2002) Patellar tendon length--the factor in patellar instability? Knee 9(1):3–6CrossRefPubMed
4.
Zurück zum Zitat Stefanik JJ, Zhu Y, Zumwalt AC, Gross KD, Clancy M, Lynch JA, Frey Law LA, Lewis CE, Roemer FW, Powers CM, Guermazi A, Felson DT (2010) Association between patella alta and the prevalence and worsening of structural features of patellofemoral joint osteoarthritis: the multicenter osteoarthritis study. Arthritis Care Res 62:1258–1265CrossRef Stefanik JJ, Zhu Y, Zumwalt AC, Gross KD, Clancy M, Lynch JA, Frey Law LA, Lewis CE, Roemer FW, Powers CM, Guermazi A, Felson DT (2010) Association between patella alta and the prevalence and worsening of structural features of patellofemoral joint osteoarthritis: the multicenter osteoarthritis study. Arthritis Care Res 62:1258–1265CrossRef
5.
Zurück zum Zitat Phillips CL, Silver DAT, Schranz PJ, Mandalia V (2010) The measurement of patellar height: a review of the methods of imaging. J Bone Joint Surg (Br) 92:1045–1053CrossRef Phillips CL, Silver DAT, Schranz PJ, Mandalia V (2010) The measurement of patellar height: a review of the methods of imaging. J Bone Joint Surg (Br) 92:1045–1053CrossRef
6.
Zurück zum Zitat Chareancholvanich K, Narkbunnam R (2012) Novel method of measuring patellar height ratio using a distal femoral reference point. Int Orthop 36:749–753PubMedCentralCrossRefPubMed Chareancholvanich K, Narkbunnam R (2012) Novel method of measuring patellar height ratio using a distal femoral reference point. Int Orthop 36:749–753PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Nizic D, Pervan M, Kovacevic B (2014) A new reference line in diagnosing a high-riding patella on routine digital lateral radiographs of the knee. Skelet Radiol 43(8):1129–37CrossRef Nizic D, Pervan M, Kovacevic B (2014) A new reference line in diagnosing a high-riding patella on routine digital lateral radiographs of the knee. Skelet Radiol 43(8):1129–37CrossRef
8.
Zurück zum Zitat Portner O, Pakzad H (2011) The evaluation of patellar height: a simple method. J Bone Joint Surg Am 93:73–80CrossRefPubMed Portner O, Pakzad H (2011) The evaluation of patellar height: a simple method. J Bone Joint Surg Am 93:73–80CrossRefPubMed
9.
Zurück zum Zitat Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101(1):101–104CrossRefPubMed Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101(1):101–104CrossRefPubMed
10.
Zurück zum Zitat Grelsamer RP, Meadows S (1992) The modified Insall-Salvati ratio for assessment of patellar height. Clin Orthop Relat Res 282:170–176PubMed Grelsamer RP, Meadows S (1992) The modified Insall-Salvati ratio for assessment of patellar height. Clin Orthop Relat Res 282:170–176PubMed
11.
Zurück zum Zitat Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Joint Surg (Br) 59:241–242 Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Joint Surg (Br) 59:241–242
12.
Zurück zum Zitat Caton J, Deschamps G, Chambat P, Lerat JL, Dejour H (1982) Patella infera. A propos of 128 cases. Rev Chir Orthop Reparatrice Appar Mot 68:317–325PubMed Caton J, Deschamps G, Chambat P, Lerat JL, Dejour H (1982) Patella infera. A propos of 128 cases. Rev Chir Orthop Reparatrice Appar Mot 68:317–325PubMed
13.
Zurück zum Zitat Berg EE, Mason SL, Lucas MJ (1996) Patellar height ratios. A comparison of four measurement methods. Am J Sports Med 24:218–221CrossRefPubMed Berg EE, Mason SL, Lucas MJ (1996) Patellar height ratios. A comparison of four measurement methods. Am J Sports Med 24:218–221CrossRefPubMed
14.
Zurück zum Zitat Lee P, Chalian M, Carrino J, Eng J, Chhabra A (2012) Multimodality correlations of patellar height measurement on X-ray, CT, and MRI. Skelet Radiol 41:1309–14CrossRef Lee P, Chalian M, Carrino J, Eng J, Chhabra A (2012) Multimodality correlations of patellar height measurement on X-ray, CT, and MRI. Skelet Radiol 41:1309–14CrossRef
15.
Zurück zum Zitat Rogers BA, Thornton-Bott P, Cannon SR, Briggs TWR (2006) Interobserver variation in the measurement of patellar height after total knee arthroplasty. J Bone Joint Surg (Br) 88:484–488CrossRef Rogers BA, Thornton-Bott P, Cannon SR, Briggs TWR (2006) Interobserver variation in the measurement of patellar height after total knee arthroplasty. J Bone Joint Surg (Br) 88:484–488CrossRef
16.
Zurück zum Zitat Smith TO, Cogan A, Patel S, Shakokani M, Toms AP, Donell ST (2013) The intra- and inter-rater reliability of X-ray radiological measurements for patellar instability. Knee 20:133–138CrossRefPubMed Smith TO, Cogan A, Patel S, Shakokani M, Toms AP, Donell ST (2013) The intra- and inter-rater reliability of X-ray radiological measurements for patellar instability. Knee 20:133–138CrossRefPubMed
17.
Zurück zum Zitat Seil R, Muller B, Georg T, Kohn D, Rupp S (2000) Reliability and interobserver variability in radiological patellar height ratios. Knee Surg Sports Traumatol Arthrosc 8:231–236CrossRefPubMed Seil R, Muller B, Georg T, Kohn D, Rupp S (2000) Reliability and interobserver variability in radiological patellar height ratios. Knee Surg Sports Traumatol Arthrosc 8:231–236CrossRefPubMed
18.
Zurück zum Zitat Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefPubMed Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefPubMed
19.
Zurück zum Zitat Fleiss JL (1981) Statistical methods for rates and proportions. Wiley, New York Fleiss JL (1981) Statistical methods for rates and proportions. Wiley, New York
20.
Zurück zum Zitat Visuri T, Pihlajamäki HK, Mattila VM, Kiuru M (2007) Elongated patellae at the final stage of Osgood-Schlatter disease: a radiographic study. Knee 14:198–203CrossRefPubMed Visuri T, Pihlajamäki HK, Mattila VM, Kiuru M (2007) Elongated patellae at the final stage of Osgood-Schlatter disease: a radiographic study. Knee 14:198–203CrossRefPubMed
21.
Zurück zum Zitat Grelsamer RP, Proctor CS, Bazos AN (1994) Evaluation of patellar shape in the sagittal plane. A clinical analysis. Am J Sports Med 22:61–66CrossRefPubMed Grelsamer RP, Proctor CS, Bazos AN (1994) Evaluation of patellar shape in the sagittal plane. A clinical analysis. Am J Sports Med 22:61–66CrossRefPubMed
22.
Zurück zum Zitat Matsuda S, Miura H, Nagamine R, Urabe K, Ikenoue T, Okazaki K, Iwamoto Y (1999) Posterior tibial slope in the normal and varus knee. Am J Knee Surg 12:165–168PubMed Matsuda S, Miura H, Nagamine R, Urabe K, Ikenoue T, Okazaki K, Iwamoto Y (1999) Posterior tibial slope in the normal and varus knee. Am J Knee Surg 12:165–168PubMed
23.
Zurück zum Zitat Yiannakopoulos CK, Mataragas E, Antonogiannakis E (2008) The effect of quadriceps contraction during weight-bearing on four patellar height indices. J Bone Joint Surg (Br) 90:870–873CrossRef Yiannakopoulos CK, Mataragas E, Antonogiannakis E (2008) The effect of quadriceps contraction during weight-bearing on four patellar height indices. J Bone Joint Surg (Br) 90:870–873CrossRef
24.
Zurück zum Zitat Defrate LE, Nha KW, Papannagari R, Moses JM, Gill TJ, Li G (2007) The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion. J Biomech 40:1716–1722PubMedCentralCrossRefPubMed Defrate LE, Nha KW, Papannagari R, Moses JM, Gill TJ, Li G (2007) The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion. J Biomech 40:1716–1722PubMedCentralCrossRefPubMed
25.
Zurück zum Zitat de Vet HCW, Terwee CB, Mokkink LB, Knol DL (2011) Reliability. In: Measurement in medicine. Cambridge University Press, Cambridge, pp 96–147CrossRef de Vet HCW, Terwee CB, Mokkink LB, Knol DL (2011) Reliability. In: Measurement in medicine. Cambridge University Press, Cambridge, pp 96–147CrossRef
Metadaten
Titel
The reliability of four widely used patellar height ratios
verfasst von
Dennis van Duijvenbode
Michel Stavenuiter
Bart Burger
Cees van Dijke
Jacco Spermon
Marco Hoozemans
Publikationsdatum
01.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 3/2016
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2908-2

Weitere Artikel der Ausgabe 3/2016

International Orthopaedics 3/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.