title: Patellofemoral alignment: reliability.
abstract: Clinical assessment of the patellofemoral alignment is frequently performed, yet the repeatability of these measurements has not been previously investigated. This study examined the reliability of measuring patellofemoral alignment. The Q angle, A angle, and patellar orientation (mediolateral tilt, mediolateral position, superoinferior tilt, and rotation) of 27 healthy subjects were measured over three trials using standardized positioning and operationally defined goniometric, pluri-cal caliper, and visual estimation measurement techniques. Intratester and intertester intraclass correlation coefficients of measurements obtained with the pluri-cal caliper and goniometer ranged from .52 to .86 and .003 to .61, respectively. Intratester and intertester standard errors of the instrumented measurements ranged from 1.6 to 3.5 degrees and 3.2 to 6.8 degrees (.28 and .55 cm for mediolateral position), respectively. Intratester kappa's of visually estimating patellar orientation ranged from .40 to .57. Intertester kappa's were between .03 and .30. The results suggest that both clinical estimation and instrumented measurement of patellofemoral alignment may be unreliable.
authors.affiliation: Henry Ford Medical Center, Center for Athletic Medicine, West Bloomfield, MI, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Tomsich
authors.forename: A J
authors.initials: AJ
authors.lastname: Nitz
authors.forename: A J
authors.initials: AJ
authors.lastname: Threlkeld
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D000328:Adult; D004867:Equipment Design; D005260:Female; D005269:Femur / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000033:anatomy & histology* / Q000502:physiology; D008023:Ligaments, Articular / Q000033:anatomy & histology* / Q000502:physiology; D008297:Male; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000502:physiology; D015588:Observer Variation; D010329:Patella / Q000033:anatomy & histology / Q000502:physiology; D015203:Reproducibility of Results