2022 AOSSM Annual Meeting Recordings with CME-The J- Sign in Patients with Patellofemoral Instability

Video Transcription

Video Summary

In this video, the speaker discusses the "J sign" as a visual evidence of patellar maltracking in relation to various factors. The severity of the J sign can vary, and attempts have been made to quantify and grade it, but the reliability of these measurements is questionable. The speaker highlights two studies that found poor inter-rater reliability when quantifying the J sign on videos. The J sign has been found to be predictive of lateral patellar translation, independent predictor of MPFL reconstruction failure, and correlated with lower PRO scores and disease-specific quality of life measurements. Risk factors for a high-grade J sign include femoral antiversion, external tibial torsion, and patella alta. Trochlear dysplasia is also a common factor in patellar femoral instability. The speaker introduces the JUPITER cohort, a study with over 2,000 patients, and provides some preliminary findings that correlate presence of the J sign with effusion, patellar translation, knee hyperextension, patellar articular length, and possibly trochlear bump. The speaker suggests considering the J sign as a multifactorial phenomenon involving rotational anatomy, patellar height, and other factors when determining interventions for patients. The speaker acknowledges the contributions of various individuals and the Jupiter investigators and research team.

Asset Caption

Jacqueline Brady, MD

Keywords

J sign

patellar maltracking

inter-rater reliability

MPFL reconstruction failure

femoral antiversion