Abstract
Purpose
The purpose of the present study was to analyze the anatomic landmarks of Schöttle’s
point and establish a locating method for identification.
Methods
From 2013 to 2016, patients undergoing medial patellofemoral ligament (MPFL) reconstruction
for patellofemoral instability were enrolled. Inclusion criteria: at least 2 episodes
of patellar dislocation. Exclusion criteria: previous knee surgeries, open physes,
severe trochlear dysplasia， tibial tuberosity lateralization, or patella alta. Group
A: From January 2013 to December 2013, preoperative 3-dimensional computed tomography
(3D-CT) images were obtained. Anatomic features of Schöttle’s point were measured
on the 3D-CT images. A Schöttle’s point locating method with 2 distinct landmarks
was established. Group B: From January 2014 to January 2016, consecutive MPFL reconstructions
were performed. The placement of Schöttle’s point was following the established method
without fluoroscopy. The accuracy of femoral tunnel positions was assessed on the
3D-CT images postoperatively.
Results
CT images of 53 knees were obtained in group A. Forty-seven MPFL reconstructions were
performed in group B. No significant difference was found between the 2 groups regarding
to demographic characteristics. The intraclass correlation coefficients were excellent
for all measures (r = 0.97). In group A, Schöttle’s point was 8.1 ± 0.2 mm (95% confidence interval [CI],
7.7-8.5) distal to the apex of the adductor tubercle and 8.0 ± 0.3 mm (95% CI, 7.4-8.6)
anterior to the posterior edge. Apex of the adductor tubercle was defined as the most
convex point, and posterior edge was defined as the edge of the posteromedial cortex
in the transition area between the medial condyle and femoral shaft. In group B, 44
of 47 femoral tunnels (93.6%) were considered localized in the proper zone.
Conclusions
Schöttle’s point was approximately 8 mm distal to the apex of the adductor tubercle
and 8 mm from the posterior edge. Schöttle’s point locating method without fluoroscopy
had high accuracy.
Level of Evidence
Level IV, case series.
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Article Info
Publication History
Published online: February 01, 2021
Accepted:
January 15,
2021
Received:
July 14,
2020
Footnotes
Hai-Jun Wang, Yi-Fan Song, and Xin Yan contributed equally to this work.
The authors report the following potential conflicts of interest or sources of funding: This work was supported by the National Natural Science Foundation of China (Grants 51773004, 81630056, 51920105006, 51803188, 31670982) and National Key Research and Development Program (Grant 2016YFC1100704). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 by the Arthroscopy Association of North America
