Abstract
Aim
To assess if there is a reproducible relationship between the width and thickness of the normal patella.
Method
43 MRI scans of young adults, average age 27 (range 17–38) were studied. Exclusion criteria included a diagnosis of degenerative joint disease, patella-femoral pathology or age under 16/over 40 (102 patients). The bony thickness of the patella, the chondral thickness and patella width were measured, as was the location of maximal patella thickness. Inter/intra observer variability was calculated and correlation analysis performed.
Results
There was a strong correlation between overall patella thickness (bone plus cartilage) and width (Pearson 0.75, P < 0.001). The width: thickness ratio is 1.8:1 (standard deviation 0.102, 95% confidence interval 1.6–2.0). The average patella cartilage thickness is 4.1mm (SD 1.3). The thickest region of the patella lies 54% (SD 2.32) from the lateral border and 54% (SD 7.9) from the superior pole.
Conclusion
We propose that the normal “Index of Patella Width: Thickness” = 1.8:1. It can be used as a guide for restoring patella thickness during TKR or patella-femoral replacement to that of a knee free from age related wear and osteoarthritis. This maximal thickness should be slightly medial and distal in the patella.
MULTIPLE DISCLOSURES
