Patella tendon anterior tibial cortex angle (PTATA): An indirect marker of anterior cruciate ligament (ACL) tear?

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-19 DOI:10.1016/j.jcot.2025.103065

Ibrahim Kanbour , Kieran Howard , Hasaam Uldin , Bhamidipaty K. Durga Prasad , David Beale , Rajesh Botchu

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引用次数: 0

Abstract

Background

Anterior cruciate ligament (ACL) injuries are common in high-impact sports. While direct MRI evaluation is preferred for diagnosis, indirect signs are often crucial. The Patella Tendon Anterior Tibial Cortex Angle (PTATA) could serve as an additional indirect marker of ACL injury, reflecting altered knee biomechanics. We hypothesise that knees presenting complete ACL rupture will exhibit a smaller PTATA on MRI due to the associated anterior tibial translation.

Methods

We reviewed 100 knee MRI scans of patients under the age of 30 years, presenting with acute knee injuries and clinical signs suggestive of ACL tear. Patients were divided into three groups: intact (Group 1), partial (Group 2), and full-thickness ACL tear (Group 3). The PTATA was measured on sagittal PDFS sequence for all patients and the mean PTATA values for each group were compared using a one-way ANOVA test.

Results

Group 1 (n = 78) had a mean PTATA of 32.32° (SD ± 6.34°, SEM ± 0.72°), Group 2 (n = 5) showed a mean of 34.00° (SD ± 5.15°, SEM ± 2.30°), while Group 3 (n = 17) demonstrated a significantly lower PTATA of 25.12° (SD ± 5.17°, SEM ± 1.25°). Group 3 had a statistically significant reduction in PTATA compared to Groups 1 and 2 (p < 0.05).

Conclusion

PTATA provides an indirect marker of ACL injury, with values below 30° demonstrating a significantly higher likelihood of a full-thickness ACL tear. This measurement is simple, easily reproducible on routine MRI and could complement existing MRI diagnostic criteria.

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髌骨肌腱胫骨前皮质角（PTATA）：前交叉韧带（ACL）撕裂的间接标志？

前交叉韧带（ACL）损伤在高强度运动中很常见。虽然直接MRI评估是诊断的首选，但间接征象往往至关重要。髌骨肌腱胫骨前皮质角（PTATA）可以作为前交叉韧带损伤的另一个间接标志，反映了膝关节生物力学的改变。我们假设，由于相关的胫骨前移位，呈现完全前交叉韧带破裂的膝关节在MRI上显示较小的PTATA。方法我们回顾了100例30岁以下患者的膝关节MRI扫描，这些患者表现为急性膝关节损伤和提示前交叉韧带撕裂的临床症状。患者分为三组：完整（1组）、部分（2组）和全层ACL撕裂（3组）。通过矢状面PDFS序列测量所有患者的PTATA，并采用单因素方差分析比较各组的PTATA平均值。结果组1 （n = 78）平均PTATA为32.32°（SD±6.34°，SEM±0.72°），组2 （n = 5）平均PTATA为34.00°（SD±5.15°，SEM±2.30°），组3 （n = 17）平均PTATA为25.12°（SD±5.17°，SEM±1.25°）。与第1组和第2组相比，第3组PTATA有统计学意义的降低(p <；0.05)。结论ptata为ACL损伤提供了一个间接标志，其值低于30°表明ACL全层撕裂的可能性显著增加。该测量方法简单，易于在常规MRI上重现，可以补充现有的MRI诊断标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.