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Background <p>In recent years intra-articular rotation of the knee (=&#xa0;knee version) has become increasingly more important, particularly in patellofemoral pathologies (maltracking/instability). It is defined as the angle between the tangent to the dorsal femoral condyles and the proximal dorsal tibial plateau. The normal value is 1.3° (±3.9°), with a&#xa0;positive value indicating tibial external rotation relative to the femur and a&#xa0;negative value indicating tibial internal rotation.</p> Diagnostics <p>The measurement is performed using torsional angle magnetic resonance imaging (MRI) or computed tomography (CT) with the knee joint extended. Recent findings suggest that knee version is increased in patients with patellofemoral maltracking (with or without instability) and concurrent torsional deformity, meaning that in these cases maltracking could possibly be exacerbated by intra-articular malrotation.</p> Operative technique <p>So far it is not sufficiently known whether knee version can be changed by conservative or surgical treatment. Theoretically, it is conceivable that a&#xa0;pathologically elevated knee version could be improved through patellar realignment procedures.</p> Conclusion <p>Knee version appears to be an additional factor in patellofemoral maltracking, although there is still insufficient information available regarding both diagnostics (is measurement possible in standard MRI at different degrees of flexion?) and treatment to make clear recommendations for action; however, it is recommended that knee version should be measured in all patients with patellofemoral maltracking as part of the torsional angle measurement.</p>

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Intraartikuläre Rotation am Kniegelenk

  • 期刊论文

  • 发表日期：

    2025年7月21日

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  • Felix Ferner,
  • Jörg Harrer

摘要

Background

In recent years intra-articular rotation of the knee (= knee version) has become increasingly more important, particularly in patellofemoral pathologies (maltracking/instability). It is defined as the angle between the tangent to the dorsal femoral condyles and the proximal dorsal tibial plateau. The normal value is 1.3° (±3.9°), with a positive value indicating tibial external rotation relative to the femur and a negative value indicating tibial internal rotation.

Diagnostics

The measurement is performed using torsional angle magnetic resonance imaging (MRI) or computed tomography (CT) with the knee joint extended. Recent findings suggest that knee version is increased in patients with patellofemoral maltracking (with or without instability) and concurrent torsional deformity, meaning that in these cases maltracking could possibly be exacerbated by intra-articular malrotation.

Operative technique

So far it is not sufficiently known whether knee version can be changed by conservative or surgical treatment. Theoretically, it is conceivable that a pathologically elevated knee version could be improved through patellar realignment procedures.

Conclusion

Knee version appears to be an additional factor in patellofemoral maltracking, although there is still insufficient information available regarding both diagnostics (is measurement possible in standard MRI at different degrees of flexion?) and treatment to make clear recommendations for action; however, it is recommended that knee version should be measured in all patients with patellofemoral maltracking as part of the torsional angle measurement.