CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(02): 252-258
DOI: 10.1055/s-0041-1734361
Original Article

Correlation between Chondromalacia Patella and Patellofemoral Factors in Middle-Age Population: A Clinical, Functional, and Radiological Analysis

Rashmeet Kaur
1   Department of Radiodiagnosis, Guru Gobind Singh Medical College, Faridkot, Punjab, India
,
Anshul Dahuja
2   Department of Orthopaedics, Guru Gobind Singh Medical College, Faridkot, Punjab, India
,
Chandanpreet Kaur
3   Department of Physical Medical Rehabilitation, Guru Gobind Singh Medical College, Faridkot, Punjab, India
,
Jagdeep Singh
2   Department of Orthopaedics, Guru Gobind Singh Medical College, Faridkot, Punjab, India
,
Paramdeep Singh
1   Department of Radiodiagnosis, Guru Gobind Singh Medical College, Faridkot, Punjab, India
,
Radhe Shyam
2   Department of Orthopaedics, Guru Gobind Singh Medical College, Faridkot, Punjab, India
› Institutsangaben

Abstract

Background Despite higher incidence of patellofemoral pain (PFP) and consequently morbidity, the understanding about PF factors leading to PF arthritis is way lacking.

Material and Methods A prospective study of first 80 patients who were diagnosed with chondromalacia patella (CMP) on magnetic resonance imaging (MRI) divided into early and late CMP groups were evaluated clinically, radiologically, and in terms of functional outcome.

Results : Quadriceps angle, Clark’s test, and Insall–Salvati ratio results were nonsignificant despite greater values were observed in late CMP group, whereas trochlear morphology results (sulcus angle: 153:138 degrees and sulcus depth 3.9:5.4 mm) and clinical scores were significant in late CMP group (Kujala’s score: 61:78, whereas PF pain score: 43:25). Type-C patellar morphology was found in greater number in late CMP cohort.

Conclusion Trochlear and patellar morphologies along with clinical scores play a key role in understanding of the CMP.



Publikationsverlauf

Artikel online veröffentlicht:
27. Juli 2021

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  • References

  • 1 Crossley KM, Stefanik JJ, Selfe J. et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med 2016; 50 (14) 839-843
  • 2 Roush JR, Curtis Bay R, Curtis Bay R. Prevalence of anterior knee pain in 18-35 year-old females. Int J Sports Phys Ther 2012; 7 (04) 396-401
  • 3 Ge Z, Li C, Heng BC, Cao G, Yang Z. Functional biomaterials for cartilage regeneration. J Biomed Mater Res A 2012; 100 (09) 2526-2536
  • 4 McCauley TR, Recht MP, Disler DG. Clinical imaging of articular cartilage in the knee. Semin Musculoskelet Radiol 2001; 5 (04) 293-304
  • 5 Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid?. Arch Phys Med Rehabil 2004; 85 (05) 815-822
  • 6 Bennell K, Bartam S, Crossley K, Green S. Outcome measures in patellofemoral pain syndrome: test retest reliability and inter-relationships. Phys Ther Sport 2000; 1: 32-41
  • 7 Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy 1993; 9 (02) 159-163
  • 8 Chhabra A, Subhawong TK, Carrino JA. A systematised MRI approach to evaluating the patellofemoral joint. Skeletal Radiol 2011; 40 (04) 375-387
  • 9 Salzmann GM, Weber TS, Spang JT, Imhoff AB, Schöttle PB. Comparison of native axial radiographs with axial MR imaging for determination of the trochlear morphology in patients with trochlear dysplasia. Arch Orthop Trauma Surg 2010; 130 (03) 335-340
  • 10 Yang B, Tan H, Yang L, Dai G, Guo B. Correlating anatomy and congruence of the patellofemoral joint with cartilage lesions. Orthopedics 2009; 32 (01) 20
  • 11 Koskinen SK, Taimela S, Nelimarkka O, Komu M, Kujala UM. Magnetic resonance imaging of patellofemoral relationships. Skeletal Radiol 1993; 22 (06) 403-410
  • 12 Crema MD, Roemer FW, Marra MD. et al. Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics 2011; 31 (01) 37-61
  • 13 Ali SA, Helmer R, Terk MR. Analysis of the patellofemoral region on MRI: association of abnormal trochlear morphology with severe cartilage defects. AJR Am J Roentgenol 2010; 194 (03) 721-727
  • 14 Gudas R, ŠiupŠinskas L, Gudaitė A. et al. The patello-femoral joint degeneration and the shape of the patella in the population needing an arthroscopic procedure. Medicina (Kaunas 2018; 54 (02) 21
  • 15 Mattila VM, Weckström M, Leppänen V, Kiuru M, Pihlajamäki H. Sensitivity of MRI for articular cartilage lesions of the patellae. Scand J Surg 2012; 101 (01) 56-61
  • 16 Pihlajamäki HK, Kuikka PI, Leppänen VV, Kiuru MJ, Mattila VM. Reliability of clinical findings and magnetic resonance imaging for the diagnosis of chondromalacia patellae. J Bone Joint Surg Am 2010; 92 (04) 927-934
  • 17 Haim A, Yaniv M, Dekel S, Amir H. Patellofemoral pain syndrome: validity of clinical and radiological features. Clin Orthop Relat Res 2006; 451 (451) 223-228
  • 18 Emami MJ, Ghahramani MH, Abdinejad F, Namazi H. Q-angle: an invaluable parameter for evaluation of anterior knee pain. Arch Iran Med 2007; 10 (01) 24-26
  • 19 Patil S, White L, Jones A, Hui AC. Idiopathic anterior knee pain in the young. A prospective controlled trial. Acta Orthop Belg 2010; 76 (03) 356-359
  • 20 Türkmen F, Acar MA, Kacıra BK. et al. A new diagnostic parameter for patellofemoral pain. Int J Clin Exp Med 2015; 8 (07) 11563-11566
  • 21 Aysin IK, Askin A, Mete BD, Guvendi E, Aysin M, Kocyigit H. Askin. Investigation of relationship between anterior knee pain, chondromalacia patella and patellofemoral malalignment. Eurasian J Med 2018; 50 (01) 28-33
  • 22 Elson DW, Jones S, Caplan N. St Clair Gibson A, Stewart S, Kader DF. Clinically insignificant association between anterior knee pain and patellofemoral lesions which are found incidentally. Knee 2013; 20 (06) 471-475
  • 23 Duran S, Cavusoglu M, Kocadal O, Sakman B. Association between trochlear morphology and chondromalacia patella: an MRI study. Clin Imaging 2017; 41: 7-10
  • 24 Mehl J, Feucht MJ, Bode G. Dovi-Akue D, Südkamp NP, Niemeyer P. Association between patellar cartilage defects and patellofemoral geometry: a matched-pair MRI comparison of patients with and without isolated patellar cartilage defects. Knee Surg Sports Traumatol Arthrosc 2016; 24 (03) 838-846
  • 25 McNally EG, Ostlere SJ, Pal C, Phillips A, Reid H, Dodd C. Assessment of patellar maltracking using combined static and dynamic MRI. Eur Radiol 2000; 10 (07) 1051-1055
  • 26 Özdemir M, Kavak RP. Chondromalacia patella among military recruits with anterior knee pain: Prevalence and association with patellofemoral malalignment. Indian J Orthop 2019; 53 (06) 682-688
  • 27 Thakkar RS, Del Grande F, Wadhwa V. et al. Patellar instability: CT and MRI measurements and their correlation with internal derangement findings. Knee Surg Sports Traumatol Arthrosc 2016; 24 (09) 3021-3028
  • 28 Tuna BK, Semiz-Oysu A, Pekar B, Bukte Y, Hayirlioglu A. The association of patellofemoral joint morphology with chondromalacia patella: a quantitative MRI analysis. Clin Imaging 2014; 38 (04) 495-498
  • 29 Loudon JK, Wiesner D, Goist-Foley HL, Asjes C, Loudon KL. Intrarater reliability of functional performance tests for subjects with patellofemoral pain syndrome. J Athl Train 2002; 37 (03) 256-261
  • 30 Doberstein ST, Romeyn RL, Reineke DM. The diagnostic value of the Clarke sign in assessing chondromalacia patella. J Athl Train 2008; 43 (02) 190-196
  • 31 de Lange-Brokaar BJE, Bijsterbosch J, Kornaat PR. et al. Radiographic progression of knee osteoarthritis is associated with MRI abnormalities in both the patellofemoral and tibiofemoral joint. Osteoarthritis Cartilage 2016; 24 (03) 473-479
  • 32 Kim HS, Yoo JH, Park NH, Chang JH, Ban YS, Song SH. Magnetic resonance imaging findings in small patella syndrome. Knee Surg Relat Res 2016; 28 (01) 75-78
  • 33 Insall J, Falvo KA, Wise DW. Chondromalacia patellae. a prospective study. J Bone Joint Surg Am 1976; 58 (01) 1-8
  • 34 Dowd GS, Bentley G. Radiographic assessment in patellar instability and chondromalacia patellae. J Bone Joint Surg Br 1986; 68 (02) 297-300
  • 35 Aglietti P, Cerulli G. Chondromalacia and recurrent subluxation of the patella: a study of malalignment, with some indications for radiography. Ital J Orthop Traumatol 1979; 5 (02) 187-201
  • 36 Lancourt JE, Cristini JA. Patella alta and patella infera. Their etiological role in patellar dislocation, chondromalacia, and apophysitis of the tibial tubercle. J Bone Joint Surg Am 1975; 57 (08) 1112-1115
  • 37 Marks KE, Bentley G. Patella alta and chondromalacia. J Bone Joint Surg Br 1978; 60 (01) 71-73