Comparative Research Of Patellar Tracking In Healthy Human And Patient With Patellofemoral Malalignment Using Volume Scan On Sensation640Slices CT

The study was divided into two parts:(1) to discuss the application value of patellartracking in healthy human using volume scan on sensation640slices CT.(2) to discuss theapplication value of patellar tracking in patient with patellofemoral malalignment usingvolume scan on sensation640slices CT. The results obtained were compared with rusultswhich got in part one.Part I An application value of tracking movement of normal patellarusing volume scan on sensation640slices CT.Objective: In the condition of non weight bearing, to discuss the application value of usingthe technology of the volume scan on sensation640slices CT healthy human for patellartracking, and to provide the range and foundation of normal vulue for patient withpatellofemoral malalignment.Materials and Methods:Research objects: The prospective pilot study enrolled20healthy human beings inKowloon Hospital from2013.9to2013.11, including15men and5women. The ageranged18~51with average of35.95years old. Both sides of the knee joint of allparticipantors (40of the knee joint in all) were examined. All the human beings receivedexamination by using volume scan on Toshiba Aquilion one sensation640slices CT.Two different methods of measuring: The participantors lay on the examining table onsensation640slices CT and put both sides of the knee on the measuring table. The femoralepicondylar of healthy human were fastened to measuring table, which was parallel tofemoral epicondylar axis. By adjusting the center of whirlbone and the midpoint of the lineof medial and lateral, we could let knee joint be parallel to the measurement station. Theposition of knee extension was the starting point to measure the instability of the knee joint. The specific methods were as follows:(1).When the knee angle was30°，We couldobtain the numeric of the femoral trochlear angle、Congruence angle、Lateralpatellofermoral angle、patellofemoral index and patellar height.(2).Data of dynamic scansof40knees was collected by using volume scan on sensation640slices CT. when the kneeangle was0°，we could establish the3D coordinate with the origin of coordinates was thecenter of the patella. The data of movement of the patellorfemoral joint was obtainedduring flexion (from0°to60°) within12s by320CT from all human beings. The3Dcoordinate of the center of patella was got to analyse the dispose relation of thepatellorfemoral joint.Results: Totally40knee-joints were measured. The results were as follows:(1).Thepatellofemoral joint stability of results of the classification for the healthy human were asfollows: Ⅰa was4（10%），Ⅰb was2（5%），Ⅳa was24（60%）， Ⅳb was10（25%），Ⅰc、Ⅳc、Ⅱ、Ⅲ was also0.(2).When the knee flexion reached0°~10°，the patellar movement was an inward movement along the X-axis, andsubsequently moved to the opposite lateral direction ever since with the knee anglechanged from20°to60°.When the knee angle changed from0°to60°，the patella movedconstantly along the Y-axis direction down. In the Z-axis, the patellar tracking was alwaysan backward movement.At first, the ranges of patellar motion was no big change. As theknee angle changed from50°to60°，the patellar movement reached the largest range.Conclusion:The functional imaging of640slices CT not only provide the conventionalnumeric which can diagnose the stability of the Patellofemoral joint, but also get the threedimensional coordinate values to provide the clinician more comprehensive information todiagnose the involution of patellofemoral joint.PartⅡ An application value of tracking movement of patients withpatellofemoral malalignment using volume scan on sensation640slices CT.Objective: In the condition of non weight bearing, to discuss the application value ofpatellar tracking in patients with patellofemoral malalignment using volume scan onsensation640slices CT, we could compare and analyze with the results which obtained in part one.Materials and Methods: The prospective pilot study enrolled20patients withpatellofemoral malalignment in Kowloon Hospital from2013.9to2013.11, including9men and11women. The age ranged18-55with average of35.55years old. Both sides ofthe knee joint of all participantors (totally40the knee joint) were examined. All thehuman beings received examination by using volume scan on Toshiba Aquilion onesensation640slices CT. The specific measuring and statistical method was the same as thepart I.Results: Totally40knee-joints were measured. The results were as follows:(1).Thepatellofemoral joint stability of results of the classification for the patients withpatellofemoral malalignment were as follows: Ⅰa was9（22.5%），Ⅰb was25（62.5%），Ⅰc was3(7.5%),Ⅲb was2(5%),Ⅳa was1（2.5%）.Ⅳb、c、Ⅱ、Ⅲa、c was also0.(2).When the knee flexion reached0°-60°，the patellarmovement was an inward constantly movement along the X-axis. With the knee anglechanged from0°to60°，the patella moved along the Y-axis direction down as the healthyhuman. In the Z-axis, the patellar tracking was always an backward significant movement.Conclusion: The traditional measurements and3D coordinate values were contrastedbetween healthy human and patients with patellofemoral malalignment. We know that thefunctional imaging scan of640slices CT not only provide the conventional numeric whichcan diagnose the stability of the Patellofemoral joint, but also get the more accuratecoordinate values to provide the clinician the new method and foundation to diagnose theinvolution of patellofemoral joint.