Academic literature on the topic 'Insall–Salvati index'

BACKGROUND: The patellofemoral join is a unique complex joint formed by articulation of the patella and the femoral trochlea. Normal measures for patellofemoral parameters have been published.
 AIM: This study aimed to describe the characteristics of patellofemoral measurements in Indonesian population using magnetic resonance imaging (MRI).
 METHODS: This descriptive total sampling study was conducted from May 2019 to August 2020. The parameters of the measurements in this study include Insall-Salvati ratio, Caton-Deschamps index, trochlear angle, lateral trochlear inclination, TT (tibia tubercle) – TG (trochlear groove) distance, and trochlear depth. The mean results of the measurements were compared with the normal value measurements that are internationally used.
 RESULTS: A total of 100 normal knees MRI scan from patients consisting of 54 (54%) males and 46 (46%) females, with an average age of 35.09 ± 12.77 (19–60) years old. The average body mass index (BMI) was 28.07 ± 3.0 (22–34). Based on ethnicity, subjects were mostly Javanese (66%), Sundanese (12%), Madura (4%), Minangkabau (7%), and the others (11%). The mean of Insall-Salvati ratio was 1.09 ± 0.17 (0.49–1.60). The mean of Caton-Deschamps index was 0.97 ± 0.16 (0.62–1.64). The mean of trochlear angle was 138.97° ± 119.7 (122°–160°). The mean of lateral trochlear inclination was 20.37° ± 4.56 (11.0°–30.6°). The mean of TT-TG distance was 13.76 ± 5.86 (4.9–41), and the mean of trochlear depth was 5.18 ± 1.87 (1.05–8.6). Those values were within normal range of international values. There were no significant differences between comparison of males and females.
 CONCLUSION: The means of Insall-Salvati ratio, Caton-Deschamps index, trochlear angle, lateral trochlear inclination, and TT-TG trochlear depth of the Indonesian people were within the international normal range, and higher than other countries’ published measurements.

Background: Numerous diagnostic imaging measurements related to patellar instability have been evaluated in the literature; however, little has been done to compare these findings across multiple studies. Purpose: To review the different imaging measurements used to evaluate patellar instability and to assess the prevalence of each measure and its utility in predicting instability. We focused on reliability across imaging modalities and between patients with and without patellar instability. Study Design: Systematic review; Level of evidence, 4. Methods: We performed a systematic review of the literature using the PubMed, SCOPUS, and Cochrane databases. Each database was searched for variations of the terms “patellar instability,” “patellar dislocation,” “trochlear dysplasia,” “radiographic measures,” “computed tomography,” and “magnetic resonance imaging.” Studies were included if they were published after May 1, 2009, and before May 1, 2019. A meta-analysis using a random effects model was performed on several measurements, comparing instability and control groups to generate pooled values. Results: A total of 813 articles were identified, and 96 articles comprising 7912 patients and 106 unique metrics were included in the analysis. The mean patient age was 23.1 years (95% CI, 21.1-24.5), and 41% were male. The tibial tubercle–trochlear groove (TT-TG) distance was the most frequently included metric (59 studies), followed by the Insall-Salvati ratio and Caton-Deschamps index (both 26 studies). The interobserver intraclass correlation coefficients were excellent or good for the TT-TG distance and Insall-Salvati ratio in 100% of studies reporting them; however, for the Caton-Deschamps index and Blackburne-Peel ratio, they were excellent or good in only 43% and 40% of studies. Pooled magnetic resonance imaging values for TT-TG distance ( P < .01), Insall-Salvati ratio ( P = .01), and femoral sulcus angle ( P = .02) were significantly different between the instability and control groups. Values for tibial tubercle–posterior cruciate ligament distance ( P = .36) and Caton-Deschamps index ( P = .09) were not significantly different between groups. Conclusion: The most commonly reported measurements for evaluating patellar instability assessed patellar tracking and trochlear morphology. The TT-TG distance was the most common measurement and was greater in the patellar instability group as compared with the control group. In addition, the TT-TG, tibial tubercle–posterior cruciate ligament, and patellar tendon–trochlear groove distances were highly reproducible measurements for patellar tracking, and the Insall-Salvati ratio had superior reproducibility for assessing patellar height.

The purpose of this study was to investigate the change in patellar position after open wedge high tibial osteotomy (OWHTO) with distal tubercle osteotomy (DTO), comparing outcomes of conventional OWHTO in young adults with proximal tibia varus deformity but no arthritic manifestations. Thirty-three patients (mean age, 31.8 years) subjected to OWHTO/DTO were matched with 30 patients (mean age, 33.5 years) undergoing conventional OWHTO. Patellar position, as measured in pre- and postoperative standing lateral radiographs, was compared. Patellar height was assessed via Insall-Salvati ratio, modified Insall-Salvati ratio, Blackburne-Peel (BP) index, Caton-Deschamps (CD) index, and modified Miura-Kawamura index. Computed tomography was used to measure lateral patellar tilt and shift. In the OWHTO group, all patellar height indices decreased significantly following surgery. Although mean values of BP and CD indices decreased significantly in the OWHTO/DTO group, other determinants of patellar height showed no significant postoperative differences. Significant postoperative declines in average lateral patellar tilt were also evident in both groups, but pre- and postoperative lateral patellar shift did not differ significantly. OWHTO/DTO can be performed without significant changes in patellar height. The results obtained support that OWHTO/DTO is suitable for relatively young patients with proximal tibia vara but no arthritic change.

The aim of this study was to evaluate if the modified Insall Salvati (IS) method can be applied for the canine patient despite differences of proximal tibial morphology, and if such potential differences are also seen in dogs with cranial cruciate ligament rupture. Insall Salvati method is a simple and convenient method for determination of the vertical position of patella, by dividing the length of patella by length of the patellar ligament. The influence of the variable proximal tibial morphology on the modified (IS) index was measured and the value of modified IS index in healthy dogs (n = 25) was compared with dogs with cranial cruciate ligament rupture (n = 26). Medio-lateral radiographs of 102 stifles were evaluated. Patellar ligament length (PLL), patellar length (PL), modified IS ratio and the height of insertion point of patellar ligament on tibial tuberosity were measured. Data of the IS ratio were compared with the value of the height of the insertion point with no significant difference (P = 0.36). There was no significant difference (P = 0.07) in the PLL:PL ratio between dogs affected or unaffected with cranial cruciate ligament rupture. Based on the results of this study we can conclude that the morphology of the cranio-proximal tibia and the height of insertion point of the patellar ligament do not have an influence on the value of the modified IS index both in healthy dogs and in dogs with cranial cruciate ligament rupture.