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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Clinical Trial

The Effect of Patellar Height by Using Insall Salvati Index on Pain, Function, Muscle Strength and Postural Stability in Patients with Primary Knee Osteoarthritis

Author(s): Pinar Doruk Analan* and Hulya Ozdemir

Volume 17, Issue 4, 2021

Published on: 17 August, 2020

Page: [532 - 538] Pages: 7

DOI: 10.2174/1573405616999200817172649

Price: $65

Abstract

Purpose: The Insall-Salvati Index (ISI) is the ratio of the patellar tendon length to the length of the patella. This ratio is the most commonly used method for evaluating patellar placement and patellofemoral imbalance. The position of the patella is important for the knee joint function and also for biomechanics. The abnormal position of the patella may lead to patellofemoral malalignment and instability. Herein, we aimed to analyze the relationship between the ISI and pain, physical function, muscle strength, fall risk, and postural stability in patients with primary knee osteoarthritis (OA).

Methods: Sixty-two symptomatic knees of 45 patients (aged between 40 -75 years) who were suffering from the primary knee OA according to the American College of Rheumatology criteria were included retrospectively in the study. Patients with stages II and III osteoarthritis according to the Kellgren-Lawrence (K/L) radiological grading system were included. The ISI was measured on the lateral knee radiograph in a 30° flexed posture. Visual Analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Lequesne indexes were recorded for evaluating pain and function. Tetrax Interactive Balance System was used to assess fall risk and postural stability. Isokinetic muscle strength measurements of quadriceps and hamstrings were recorded at the constant angular velocities of 60 and 180°/sec.

Results: The mean age of the study population was 58.52 ±8.01 years. The frequency of the patellar situation types was as follows; patella alta; 15 (24.2%), patella baja; n=2(3.2%), and normal patellar height; n=45(72.6%). The mean ISI was 1.19 ±0.17 on the right side and 1.18±0.16 on the left side. There was no significant correlation between the ISI and VAS, WOMAC and Lequesne indexes, postural stability scores, and isokinetic measurements (r<0.3, p>0.05).

Conclusion: In primary knee OA, the ISI may not have an effect on pain, physical function, fall risk, postural stability, and isokinetic muscle strength. Clinical Trial Registration Number: KA18/170.

Keywords: Insall-Salvati index, pain, function, muscle strength, postural stability, primary knee osteoarthritis.

Graphical Abstract

[1]
Kobayashi S, Pappas E, Fransen M, Refshauge K, Simic M. The prevalence of patellofemoral osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage 2016; 24(10): 1697-707.
[http://dx.doi.org/10.1016/j.joca.2016.05.011] [PMID: 27188684]
[2]
Kim D, Park G, Kuo LT, Park W. The effects of pain on quadriceps strength, joint proprioception and dynamic balance among women aged 65 to 75 years with knee osteoarthritis. BMC Geriatr 2018; 18(1): 245.
[http://dx.doi.org/10.1186/s12877-018-0932-y] [PMID: 30332992]
[3]
Kim HS, Yun DH, Yoo SD, et al. Balance control and knee osteoarthritis severity. Ann Rehabil Med 2011; 35(5): 701-9.
[http://dx.doi.org/10.5535/arm.2011.35.5.701] [PMID: 22506194]
[4]
Giovagnorio F, Olive M, Casinelli A, et al. Comparative US-MRI evaluation of the Insall-Salvati index. Radiol Med (Torino) 2017; 122(10): 761-5.
[http://dx.doi.org/10.1007/s11547-017-0781-3] [PMID: 28664487]
[5]
Haj-Mirzaian A, Guermazi A, Pishgar F, et al. Association of patella alta with worsening of patellofemoral osteoarthritis-related structural damage: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2019; 27(2): 278-85.
[http://dx.doi.org/10.1016/j.joca.2018.10.013] [PMID: 30445221]
[6]
Stefanik JJ, Zumwalt AC, Segal NA, Lynch JA, Powers CM. Association between measures of patella height, morphologic features of the trochlea, and patellofemoral joint alignment: the MOST study. Clin Orthop Relat Res 2013; 471(8): 2641-8.
[http://dx.doi.org/10.1007/s11999-013-2942-6] [PMID: 23546847]
[7]
Hiemstra LA, Kerslake S, Lafave MR, Tucker A. Patella alta is reduced following MPFL reconstruction but has no effect on quality-of-life outcomes in patients with patellofemoral instability. Knee Surg Sports Traumatol Arthrosc 2020; 29(2): 546-2.
[http://dx.doi.org/10.1007/s00167-020-05977-8] [PMID: 32274546]
[8]
Verhulst FV, van Sambeeck JDP, Olthuis GS, van der Ree J, Koëter S. Patellar height measurements: Insall-Salvati ratio is most reliable method. Knee Surg Sports Traumatol Arthrosc 2020; 28(3): 869-75.
[http://dx.doi.org/10.1007/s00167-019-05531-1] [PMID: 31089790]
[9]
Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16(4): 494-502.
[http://dx.doi.org/10.1136/ard.16.4.494] [PMID: 13498604]
[10]
Kar M, Bhaumik D, Deb S, Ishore K, Kar C. Comparative study on insall-salvati index by radiological and clinical methods in a tertiary care centre of north Bengal, India. J Clin Diagn Res 2017; 11(3): AC05-7.
[http://dx.doi.org/10.7860/JCDR/2017/25434.9363] [PMID: 28511364]
[11]
Yılmaz B, Ozdemir G, Sirin E, Cicek ED, Anıl BS, Bulbun G. Evaluation of patella alta using MRI measurements in adolescents. Indian J Radiol Imaging 2017; 27(2): 181-6.
[http://dx.doi.org/10.4103/ijri.IJRI_222_16] [PMID: 28744079]
[12]
Franco BAFM, Sadigursky D, Daltro GC. Patellar position in patients with patellofemoral syndrome as characterized by anatomo-radiographic study. Rev Bras Ortop 2018; 53(4): 410-4.
[http://dx.doi.org/10.1016/j.rboe.2017.05.011] [PMID: 30027071]
[13]
Park JH. The effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema: a single-blind, randomized controlled trial. Breast Cancer 2017; 24(4): 608-14.
[http://dx.doi.org/10.1007/s12282-016-0747-7] [PMID: 28008557]
[14]
Basaran S, Guzel R, Seydaoglu G, Guler-Uysal F. Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis. Clin Rheumatol 2010; 29(7): 749-56.
[http://dx.doi.org/10.1007/s10067-010-1398-2] [PMID: 20169459]
[15]
Cavanellas NT, Cossich VRA, Nicoliche EB, Martins MB, Sousa EB, Salles JI. Comparative analysis of quadriceps and hamstrings strength in knee osteoarthritis before and after total knee arthroplasty: a cross-sectional study. Rev Bras Ortop 2018; 53(2): 158-64.
[http://dx.doi.org/10.1016/j.rboe.2018.02.009] [PMID: 29911081]
[16]
Doruk P, Adam M, Leblebici B, et al. The effects of physical medicine and rehabilitation modalities on muscle strength and postural stability of primary knee osteoarthritis. J PMR Sci 2013; 16: 55-61.
[17]
Cetin N, Aytar A, Atalay A, Akman MN. Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial. Am J Phys Med Rehabil 2008; 87(6): 443-51.
[http://dx.doi.org/10.1097/PHM.0b013e318174e467] [PMID: 18496246]
[18]
Akkaya N, Doğanlar N, Çelik E, et al. Test-retest reliability of Tetrax® static posturography system in young adults wıth low physical activity level. Int J Sports Phys Ther 2015; 10(6): 893-900.
[PMID: 26618068]
[19]
Haj-Mirzaian A, Guermazi A, Pishgar F, et al. Patellofemoral morphology measurements and their associations with tibiofemoral osteoarthritis-related structural damage: exploratory analysis on the osteoarthritis initiative. Eur Radiol 2020; 30(1): 128-40.
[http://dx.doi.org/10.1007/s00330-019-06324-3] [PMID: 31297634]
[20]
Özgül A, Günendi Z, Kesikburun S, Omaç ÖK, Taşkaynatan MA. The association between patellar alignments features and tibiofemoral joint osteoarthritis. Clin Rheumatol 2013; 32(7): 1017-20.
[http://dx.doi.org/10.1007/s10067-013-2222-6] [PMID: 23515598]
[21]
Coskun Benlidayi I, Cuzdan Coskun N, Sarpel T. SAT0451 the association of patella alta with the severity of radiological tibiofemoral knee osteoarthritis. Ann Rheum Dis 2016; 75: 835.
[http://dx.doi.org/10.1136/annrheumdis-2016-eular.4046]
[22]
Duman I, Taskaynatan MA, Mohur H, Tan AK. Assessment of the impact of proprioceptive exercises on balance and proprioception in patients with advanced knee osteoarthritis. Rheumatol Int 2012; 32(12): 3793-8.
[http://dx.doi.org/10.1007/s00296-011-2272-5] [PMID: 22187058]
[23]
Hassan BS, Mockett S, Doherty M. Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis 2001; 60(6): 612-8.
[http://dx.doi.org/10.1136/ard.60.6.612] [PMID: 11350851]
[24]
Rabe KG, Matsuse H, Jackson A, Segal NA. Evaluation of the combined application of neuromuscular electrical stimulation and volitional contractions on thigh muscle strength, knee pain, and physical performance in women at risk for knee osteoarthritis: A randomized controlled trial. PM R 2018; 10(12): 1301-10.
[http://dx.doi.org/10.1016/j.pmrj.2018.05.014] [PMID: 29852286]
[25]
Bobić Lucić L, Grazio S. Impact of balance confidence on daily living activities of older people with knee osteoarthritis with regard to balance, physical function, pain, and quality of life - a preliminary report. Clin Gerontol 2018; 41(4): 357-65.
[http://dx.doi.org/10.1080/07317115.2018.1453907] [PMID: 29617207]
[26]
Esfandiari E, Sanjari MA, Ashraf Jamshidi A, Kamyab M, Yazdi HR. Knee osteoarthritis at the early stage: The four-week effect of lateral wedge insole on pain and risk of falls. Med J Islam Repub Iran 2018; 32: 17.
[http://dx.doi.org/10.14196/mjiri.32.17] [PMID: 30159268]

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