Patellar tendon – lateral femoral kondil sürtünme sendromu ile patellofemoral instabilite arasındaki ilişki

Year 2020, Volume: 11 Issue: 3, 161 - 167, 22.06.2020

Rasime Pelin Kavak Evrim Duman Meltem Özdemir

https://doi.org/10.18663/tjcl.696749

Abstract

Amaç: Patellar tendon-lateral femoral kondil sürtünme sendromunun (PTLFKSS) etiyolojisi tam olarak bilinmemektedir ve PTLFKSS'unun tanısı, tedavisi ve prognozu ile ilgili çalışmaların sayısı sınırlıdır. Bu çalışmada amacımız PTLFKSS ile patellofemoral instabilite ilişkisini değerlendirmekti.
Gereç ve Yöntemler: Diz manyetik rezonans görüntülemesinde (MRG) PTLFKSS saptanan hastalarda (çalışma grup n=82) ve PTLFKSS saptanmayan hastalarda (kontrol grup n=204) patellofemoral stabiliteyi değerlendirmek için altı morfolojik parametre MRG’de ölçüldü. Bu parametreler Insall-Salvati oranı, ön troklear çıkıntı, sulkus açısı, lateral troklear eğim açısı, patellar eğim açısı ve pateller laterilizasyon ölçümü idi. Ayrıca kondromalazik patella ilişkisi de değerlendirildi.
Bulgular: Çalışma grubunda kontrol grubuna göre Insall-Salvati oranı, patellar eğim açısı, patellar lateralizasyon, sulkus açısı ve ön troklear çıkıntı anlamlı olarak daha yüksek ve lateral troklear eğim açısı ise anlamlı olarak daha düşük bulundu. Kondromalazik patella insidansı çalışma grubunda anlamlı derecede yüksekti. Çalışma grubunda kondromalazik patella ile ön troklear çıkıntı arasında pozitif bir korelasyon vardı.
Sonuç: PTLFKSS' ye sebep olan faktörler arasında patellofemoral instabilitenin etkili olduğu bulundu. Ölçülen parametrelerin yüksek sensitivite ve spesifiteye sahip olması; bu parametrelerin hem risk faktörü, hem de tanıda kullanılabileceği önerilmektedir.
Anahtar kelimeler: Patellar tendon-lateral femoral kondil sürtünme sendromu; patellar insitabilite; manyetik rezonans görüntüleme

Keywords

Patellar tendon-lateral femoral kondil sürtünme sendromu, patellar insitabilite, manyetik rezonans görüntüleme

Relationship between patellar tendon–lateral femoral condyle friction syndrome and patellofemoral instability

Abstract

Aim: The etiology of the patellar tendon–lateral femoral condyle friction syndrome (PTLFCFS) is not fully known and the number of studies on the diagnosis, treatment, and prognosis of PTLFCFS is limited. The aim of this study was to evaluate the relationship between PTLFCFS and patellofemoral instability in magnetic resonance imaging
Material and Methods: Six morphological parameters were measured in magnetic resonance imaging (MRI) to evaluate patellofemoral stability in patients with PTLFCFS (study group n = 82) and patients without detection PTLFCFS (control group n = 204) in the knee MRI examination. These parameters include the Insall–Salvati ratio, ventral trochlear prominence, sulcus angle, lateral trochlear inclination angle, patellar inclination angle, and patellar lateralization measurement. In addition, the chondromalacia patella relationship was also evaluated.
Results: The Insall–Salvati ratio, patellar inclination angle, patellar lateralization, sulcus angle, and ventral trochlear prominence were significantly higher and lateral trochlear inclination angle was significantly lower in the study group than in the control group. The incidence of chondromalacia patella was significantly higher in the study group. In the study
group, there was a positive correlation between the chondromalacia patella and the ventral trochlear prominence.
Conclusion: Among the factors causing PTLFCFS, patellofemoral instability was found to be effective. The measured parameters having high sensitivity and specificity suggest that these parameters can be used as risk factors and for the diagnosis.

Keywords

Patellar tendon–lateral femoral condyle friction syndrome, patellofemoral instability, magnetic resonance imaging

References

• 1. Li J, Sheng B, Yu F, Guo C, Lv F, Lv F, et al. Quantitative magnetic resonance imaging in patellar tendon-lateral femoral condyle friction syndrome: relationship with subtle patellofemoral instability. Skeletal Radiol 2019; 48: 1251-59.
• 2. Fontanella CG, Carniel EL, Frigo A et al. Investigation of biomechanical response of Hoffa's fat pad and comparative characterization. J Mech Beh Biomed Mater 2017; 67: 1-9.
• 3. Matcuk Jr GR, Cen SY, Keyfes V, Patel DB, Gottsegen CJ, White EA. Superolateral Hoffa fat-pad edema and patellofemoral maltracking: predictive modeling. AJR Am J Roentgenol. 2014; 203: 207–12.
• 4. Barbier-Brion B, Lerais J-M, Aubrey S, Lepage D, Vidal C, Delabrousse E et al. Magnetic resonance imaging in patellar lateral femoral friction syndrome (PLFFS): prospective case-control study. Diagn Interv Imaging 2012; 93: 171-82.
• 5. Chung CB, Skaf A, Roger B, Campos J, Stump X, Resnick D. Patellar tendon–lateral femoral condyle friction syndrome: MR imaging in 42 patients. Skeletal Radiol 2001; 30: 694-97.
• 6. Jibri Z, Martin D, Mansour R, Kamath S. The association of infrapatellar fat pad oedema with patellar maltracking: a case–control study. Skeletal Radiol 2012; 41: 925-31.
• 7. Subhawong TK, Thakkar RS, Padua A, Flammang A, Chhabra A, Carrino JA. Patellofemoral Friction Syndrome: MRI correlation of morphologic and T2 cartilage imaging. J Comput Assist Tomogr 2014; 38: 308-12.
• 8. Munch JL, Sullivan JP, Nguyen JT, Mintz D, Green DW, Shubin Stein BE et al. Patellar articular overlap on MRI is a simple alternative to conventional measurements of patellar height. Orthop J Sports Med 2016; 4: 2325967116656328.
• 9. Widjajahakim R, Roux M, Jarraya M, Roemer FW, Neogi T, Lynch JA et al. Relationship of trochlear morphology and patellofemoral joint alignment to superolateral hoffa fat pad edema on MR Images in individuals with or at risk for osteoarthritis of the knee: The MOST study. Radiology 2017; 284: 806-14.
• 10. Bonadio MB, Helito CP, do Prado Torres JA, Gobbi RG, Pécora JR, Camanho GL et al. Plateau–patella angle: An option for the evaluation of patellar height in patients with patellar instability. The Knee 2017; 24: 340-44.
• 11. Campagna R, Pessis E, Biau DJ, Guerini H, Feydy A, Thevenin FS et al. Is superolateral Hoffa fat pad edema a consequence of impingement between lateral femoral condyle and patellar ligament? Radiology 2012; 263: 469-74.
• 12. Gürsoy M, Mete BD, Oyar O, Erdoğan N, Uluç ME, Bulut T et al. The association of patellar maltracking with infrapatellar fat pad edema and chondromalacia patella: A quantitative morphological magnetic resonance imaging analysis. Turk J Phys Med Rehab 2018; 64: 246-52.