A total of 331 patients who underwent total knee arthroplasty at our institution with radiographs prior to surgery were evaluated. Of those, 297 (89.2%) were felt to be adequate for review. Three observers with different levels of orthopedic training measured PPA, Insall–Salvati, Caton–Deschamps, and Blackburne–Peel indices on a subset of 50 consecutive patients. Interobserver agreement for each of the four measurements was calculated and correlation between each of the measurements within each observer was calculated. The measurement of the PPA was repeated. Intraobserver agreement for the PPA was determined and a normal range and distribution was defined for this population.
For the three observers, the mean PPA for the entire cohort was 25.55, 25.31, and 24.42. The intraclass correlation coefficient (ICC) was 0.81, The ICC and intraobserver assessment were the highest for the PPA compared with the other ratios. The PPA was found to correlate most strongly with the Blackburne–Peel method.
The plateau-patella angle is a reliable way to evaluate patellar height in the osteoarthritic population. The measurement demonstrated a higher interobserver reliability compared with previously described methods.
Retrospective Level IV.