Torsion of the Tibial Tuberosity, a New Factor of Patellar Instability?

Completed

Brief Summary: Patellar instability (recurrent patellar dislocation) can occur at any age. It is most often seen in young subjects, especially among adolescents. It is commonly accompanied by anatomical factors. A new factor not described in bibliographic sources and characterized by an external torsion of the tibial tuberosity is frequently found in patients with patellar instability thanks to MRIs. This does not seem to be the case when there is no patellar pathology. A statistical study is needed to assess this rotary anomaly. Validate the predictive benefits when measuring the torsion of tibial tuberosity in cases with recurrent patellar dislocation.

Detailed Description: Patellar instability (recurrent patellar dislocation) can occur at any age. It is most often seen in young subjects, especially among adolescents. It is commonly accompanied by anatomical factors known to be driving: Dysplasia of the trochlea, patella alta, lateralisation of the tibial tuberosity, patellar torsion and misalignment, tearing of the Medial Patello Femoral Ligament... The assessment of these factors is essential to evaluate the instability and guide the procedures of the surgical treatment. MRIs have become an important test for the analysis and measurement of these factors. A new factor not described in bibliographic sources and characterized by an external torsion of the tibial tuberosity is frequently found in patients with patellar instability thanks to MRIs. This does not seem to be the case when there is no patellar pathology. A statistical study is needed to assess this rotary anomaly. It will be necessary to take it into account in the future regarding indications and techniques for tibial tuberosity osteotomies, often used to correct patellar instability.

Recruitment & Eligibility

Inclusion Criteria

Men or women
Subjects who have not expressed opposition to the use of the data for research purposes

Clinical criteria:

Unstable group:
- Medical history with 2 patellar dislocations or more,
- with or without requiring surgical treatment after an MRI Control group: Men or women over 18 years old
- Subjects who have not expressed opposition to the use of the data for research purposes
Control group:
- Patients showing meniscal injury on MRI who may or may not have been treated (meniscectomy or stitches)

Exclusion Criteria

Unstable group:
- MRI performed on one knee operated for patellar instability
- Associated tearing of the ligament (ACL, PCL)
Control group:
- Patients with a medical history of patellar pathology
- Patients with associated ligament injury (ACL, PCL)

Primary Outcome Measures

Name	Time	Method
Existence of Tibial Tuberosity Torsion.	4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable.	This criteria will be considered relevant if it is associated with patellar dislocation. Existence Yes or No and measure of the torsion in degre on the IRM

Secondary Outcome Measures

Name	Time	Method
Distance TT-TG Tibial Tuberosity and Trochlear Groove	4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable.	distance between Tibial Tuberosity and Trochlear Groove
Measure of Patellar Tilt	4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable. Unit in degre	Patellar Tilt (yes or no), based on a patient IRM. Unit in degre.