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  • #13662
    Dr R Young

    Patellar position is inaccurate on MR/CT as static and knee may not be fully extended.
    Patella tends to sublux more superiorly when out of trochlear groove.
    Mention patellar morphology and lat/med cartilage.

    Measurements are not that accurate or relevant due to positioning in MRI.
    Patellar trochlear index (PTR) tends to be used to check for patella alta.
    Tibial tuberosity – trochlear groove (TTTG) is also requested commonly.
    Patellar fat pad oedema is important to mention as often provides an inflammatory contributor to symptoms.
    Also need to mention patellar tilt and integrity of medial patellofemoral ligament (MPFL).

    Physiotherapy – gluteal strengthening is important for patellar tracking (works via TFL and ITB). Better to use phased quads strengthening as squats can be too much and/or too painful to start with.
    Physiotherapy can take 1 year to work with muscle weakness and hypermobility.
    Muscle stimulators can help for vastus medialis oblique (VMO) strengthening.
    Win-win – avoid surgery or good preparation for surgery.

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