121. DOES THE CATON AND DESCHAMPS INDEX ASSESS THE RELIABILITY OF PATELLAR HEIGHT IN CHILDREN AND ADOLESCENTS? DESCRIPTIVE STUDY OF 300 PATIENTS

Abstract

Purpose of the study: Variations in patellar height in relation to the trochlea and the joint line can be a cause of pain and instability and limit the range of knee flexion. The Caton and Deschamps index (CDI) was described and validated in a cohort of adult subjects. The purpose of this work was to validate this index and set the reference values in a paediatric population.

Material and methods: Lateral view of the knee were obtained in 300 patients who consulted for minor trauma without ligament or bone injury. Thirty patients, aged 6 to 15 years, were included in each age group (1-year groups). All radiographs were qualified as normal by the radiologist. Two series of measures were made in random order and at an interval of 8 days by two independent observers. The patellar height and the length of the patellar tendon were measured with computer assistance. The interob-server and intraobserver variabilities were determined.

Results: The mean patellar height was 33.39±7.40 mm. The mean length of the patellar tendon was 34.57±67.36 mm. The mean CDI was 1.06±0.21. There was not significant correlation between patient age, height of the patella and length of the patellar tendon. Thus the height of the patella and the length of the patellar tendon increased with age while the CDI was statistically lower in older patients. The height of the patella was identical in the two genders while the patellar tendon was statistically longer in boys. The CDI was statistically higher in boys. Interobserver and intraobserver agreement was excellent.

Discussion: CDI is a simple and reproducible measurement in adults and in children and adolescents. During growth, it is an alternative to the Insall index which has limited reproducibility and the Koshino index which is difficult to use in routine clinical situations. We found a correlation between CDI and children’s age, related to progressive ossification of the patella.

Conclusion: The CDI is a tool which can be used in routine practice to study patellofemoral problems in the paediatric population as long as the physiological values are weighted by age.