Research Article
BibTex RIS Cite

A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle is Associated with Greater Trochlear Sulcus Angle

Year 2024, Volume: 14 Issue: 2, 531 - 537, 28.06.2024
https://doi.org/10.33808/clinexphealthsci.1284587

Abstract

Objective: In this study, the relationship between patella angle - trochlear sulcus angle (TSA) discrepancy was investigated. A specific cutoff value of patella angle (PA), TSA, trochlear groove depth (TGD), and medial trochlear/lateral trochlear length (MT/LT) ratio for effusion, fat-pad edema, chondromalacia, meniscal and ligament tear were investigated. By doing so, to the best of our knowledge, we bridged the gap in literature since these relationships between the above-mentioned measurements have almost never been examined.
Methods: A total of 446. patients were evaluated on magnetic resonance imaging. PA and TSA were calculated with. the highest specificity and sensitivity in predicting effusion, fat-pad edema, and patellar chondromalacia. A specific cutoff value of PA, TSA, TGD and MT/LT for effusion, fat-pad edema, chondromalacia, meniscal tear, and ligament tear were investigated.
Results: A low-level and insignificant correlation was found between PA and TSA in the negative direction. TSA value. with the highest sensitivity and specificity in predicting the presence of effusion, fat-pad, and chondromalacia was found ≤131, ≤129.6, and >125.8, respectively. Tibial tubercle-trochlear groove (TT-TG) distance. measurement was significantly less in the group with Medial Meniscus (MM) rupture. Increased TT-TG distance posed a risk for quadriceps tendinosis 1.127 times and increased medial trochlea length (MT) posed a risk for quadriceps tendinosis 1.167 times.
Conclusion: Certain cutoff values of PA and TSA may predispose risk for meniscal tear, effusion, fat-pad edema, and chondromalacia. A negative correlation was present between the patella angle and TSA.

References

  • Cerveri P, Belfatto A, Manzotti A. Representative 3D shape of the distal femur, modes of variation and relationship with abnormality of the trochlear region. Journal of biomechanics. 2019;94: 67–74. DOI:10.1016/j.jbiomech.2019.07.008
  • Cilengir AH, Cetinoglu YK, Kazimoglu C, Gelal MF, Mete BD, Elmali F, Tosun O. The relationship between patellar tilt and quadriceps patellar tendon angle with anatomical variations and pathologies of the knee joint. European Journal of Radiology. 2021;139: 109719. DOI:10.1016/j.ejrad.2021.109719
  • Gupta H, Kataria H, Batta NS, Yadav S, Jain V. Assessment of validity and reliability of femoral shaft-patellar tendon angle measured on MRI. Skeletal radiology. 2021;50(5): 927–936. DOI:10.1007/s00256-020-03636-0
  • Oğuzdoğan GY, Arslan FZ. Evaluation of Anatomical Variations with Morphological Measurements and Their Relationship to Meniscal Injury and Ligament Damage. J Knee Surg. 2023;36(13):1357-1364. DOI:10.1055/a-1933-3592
  • Damgacı L, Özer H, Duran S. Patella-patellar tendon angle and lateral patella-tilt angle decrease patients with chondromalacia patella. Knee surgery, sports traumatology, arthroscopy : Official journal of the ESSKA. 2020;28(8): 2715–2721. DOI:10.1007/s00167-020-06065-7
  • Neyret P, Robinson AH, Le Coultre B, Lapra C, Chambat P. Patellar tendon length--the factor in patellar instability? The Knee. 2002;9(1): 3–6. DOI:10.1016/s0968-0160(01)00136-3
  • Verhulst FV, van Sambeeck JDP, Olthuis GS, van der Ree J, Koëter S. Patellar height measurements: Insall-Salvati ratio is most reliable method. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2020;28(3): 869–875. DOI:10.1007/s00167-019-05531-1
  • Wolfe S, Varacallo M, Thomas JD, Carroll JJ, Kahwaji CI. Patellar Instability. 2023 Sep 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29494034.
  • Duran S, Cavusoglu M, Kocadal O, Sakman B. Association between trochlear morphology and chondromalacia patella: an MRI study. Clinical imaging. 2017;41: 7–10. DOI:10.1016/j.clinimag.2016.09.008
  • Li CA, Kim MK, Kim IH, Lee JH, Jang KY, Lee SY. Correlation of histological examination of meniscus with MR images: Focused on high signal intensity of the meniscus not caused by definite meniscal tear and impact on mr diagnosis of tears. Korean journal of radiology. 2013;14(6): 935–945. DOI:10.3348/kjr.2013.14.6.935
  • Levy BJ, Tanaka MJ, Fulkerson JP. Current Concepts Regarding Patellofemoral Trochlear Dysplasia. The American journal of sports medicine. 2021;49(6): 1642–1650. DOI:10.1177/0363546520958423
  • Aysin IK, Askin A, Mete BD, Guvendi E, Aysin M, Kocyigit H. Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment. The Eurasian journal of medicine. 2018;50(1): 28–33. DOI:10.5152/eurasianjmed.2018.17277
  • Yang B, Tan H, Yang L, Dai G, Guo B. Correlating anatomy and congruence of the patellofemoral joint with cartilage lesions. Orthopedics. 2009;32(1): 20. DOI:10.3928/01477447-20090101-27
  • Kalichman L, Zhang Y, Niu J, Goggins J, Gale D, Felson DT, Hunter D. The association between patellar alignment and patellofemoral joint osteoarthritis features--an MRI study. Rheumatology (Oxford, England). 2007;46(8): 1303–1308. DOI:10.1093/rheumatology/kem095
  • Paiva M, Blønd L, Hölmich P, Steensen RN, Diederichs G, Feller JA, Barfod KW. Quality assessment of radiological measurements of trochlear dysplasia; a literature review. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2018;26(3): 746–755. DOI:10.1007/s00167-017-4520-z
  • Carrillon Y, Abidi H, Dejour D, Fantino O, Moyen B, Tran-Minh VA. Patellar instability: Assessment on MR images by measuring the lateral trochlear inclination-initial experience. Radiology. 2000;216(2): 582–585. DOI:10.1148/radiology.216.2.r00au07582
  • Joseph SM, Cheng C, Solomito MJ, Pace JL. Lateral Trochlear Inclination Angle: Measurement via a 2-Image Technique to Reliably Characterize and Quantify Trochlear Dysplasia. Orthopaedic journal of sports medicine. 2020;8(10): 2325967120958415. DOI:10.1177/2325967120958415
  • Keser S, Savranlar A, Bayar A, Ege A, Turhan E. Is there a relationship between anterior knee pain and femoral trochlear dysplasia? Assessment of lateral trochlear inclination by magnetic resonance imaging. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2008;16(10): 911–915. DOI:10.1007/s00167-008-0571-5
  • Hochreiter B, Hirschmann MT, Amsler F, Behrend H. Highly variable tibial tubercle-trochlear groove distance (TT-TG) in osteoarthritic knees should be considered when performing TKA. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA. 2019;27(5): 1403–1409. DOI:10.1007/s00167-018-5141-x
  • Imhoff FB, Funke V, Muench LN, Sauter A, Englmaier M, Woertler K, Imhoff AB, Feucht MJ. Correction to: The complexity of bony malalignment in patellofemoral disorders: femoral and tibial torsion, trochlear dysplasia, TT-TG distance, and frontal mechanical axis correlate with each other. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2020;28(3):897-904. DOI:10.1007/s00167-019-05542-y
  • Biedert RM, Albrecht S. The patellotrochlear index: a new index for assessing patellar height. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA. 2006;14(8): 707–712. DOI:10.1007/s00167-005-0015-4
  • Harbaugh CM, Wilson NA, Sheehan FT. Correlating femoral shape with patellar kinematics in patients with patellofemoral pain. Journal of orthopaedic research: Official publication of the Orthopaedic Research Society. 2010;28(7): 865–872. DOI:10.1002/jor.21101
  • Endo Y, Schweitzer ME, Bordalo-Rodrigues M, Rokito AS, Babb JS. MRI quantitative morphologic analysis of patellofemoral region: Lack of correlation with chondromalacia patellae at surgery. AJR. American journal of roentgenology. 2007;189(5): 1165–1168. DOI:10.2214/AJR.07.2236
Year 2024, Volume: 14 Issue: 2, 531 - 537, 28.06.2024
https://doi.org/10.33808/clinexphealthsci.1284587

Abstract

References

  • Cerveri P, Belfatto A, Manzotti A. Representative 3D shape of the distal femur, modes of variation and relationship with abnormality of the trochlear region. Journal of biomechanics. 2019;94: 67–74. DOI:10.1016/j.jbiomech.2019.07.008
  • Cilengir AH, Cetinoglu YK, Kazimoglu C, Gelal MF, Mete BD, Elmali F, Tosun O. The relationship between patellar tilt and quadriceps patellar tendon angle with anatomical variations and pathologies of the knee joint. European Journal of Radiology. 2021;139: 109719. DOI:10.1016/j.ejrad.2021.109719
  • Gupta H, Kataria H, Batta NS, Yadav S, Jain V. Assessment of validity and reliability of femoral shaft-patellar tendon angle measured on MRI. Skeletal radiology. 2021;50(5): 927–936. DOI:10.1007/s00256-020-03636-0
  • Oğuzdoğan GY, Arslan FZ. Evaluation of Anatomical Variations with Morphological Measurements and Their Relationship to Meniscal Injury and Ligament Damage. J Knee Surg. 2023;36(13):1357-1364. DOI:10.1055/a-1933-3592
  • Damgacı L, Özer H, Duran S. Patella-patellar tendon angle and lateral patella-tilt angle decrease patients with chondromalacia patella. Knee surgery, sports traumatology, arthroscopy : Official journal of the ESSKA. 2020;28(8): 2715–2721. DOI:10.1007/s00167-020-06065-7
  • Neyret P, Robinson AH, Le Coultre B, Lapra C, Chambat P. Patellar tendon length--the factor in patellar instability? The Knee. 2002;9(1): 3–6. DOI:10.1016/s0968-0160(01)00136-3
  • Verhulst FV, van Sambeeck JDP, Olthuis GS, van der Ree J, Koëter S. Patellar height measurements: Insall-Salvati ratio is most reliable method. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2020;28(3): 869–875. DOI:10.1007/s00167-019-05531-1
  • Wolfe S, Varacallo M, Thomas JD, Carroll JJ, Kahwaji CI. Patellar Instability. 2023 Sep 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29494034.
  • Duran S, Cavusoglu M, Kocadal O, Sakman B. Association between trochlear morphology and chondromalacia patella: an MRI study. Clinical imaging. 2017;41: 7–10. DOI:10.1016/j.clinimag.2016.09.008
  • Li CA, Kim MK, Kim IH, Lee JH, Jang KY, Lee SY. Correlation of histological examination of meniscus with MR images: Focused on high signal intensity of the meniscus not caused by definite meniscal tear and impact on mr diagnosis of tears. Korean journal of radiology. 2013;14(6): 935–945. DOI:10.3348/kjr.2013.14.6.935
  • Levy BJ, Tanaka MJ, Fulkerson JP. Current Concepts Regarding Patellofemoral Trochlear Dysplasia. The American journal of sports medicine. 2021;49(6): 1642–1650. DOI:10.1177/0363546520958423
  • Aysin IK, Askin A, Mete BD, Guvendi E, Aysin M, Kocyigit H. Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment. The Eurasian journal of medicine. 2018;50(1): 28–33. DOI:10.5152/eurasianjmed.2018.17277
  • Yang B, Tan H, Yang L, Dai G, Guo B. Correlating anatomy and congruence of the patellofemoral joint with cartilage lesions. Orthopedics. 2009;32(1): 20. DOI:10.3928/01477447-20090101-27
  • Kalichman L, Zhang Y, Niu J, Goggins J, Gale D, Felson DT, Hunter D. The association between patellar alignment and patellofemoral joint osteoarthritis features--an MRI study. Rheumatology (Oxford, England). 2007;46(8): 1303–1308. DOI:10.1093/rheumatology/kem095
  • Paiva M, Blønd L, Hölmich P, Steensen RN, Diederichs G, Feller JA, Barfod KW. Quality assessment of radiological measurements of trochlear dysplasia; a literature review. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2018;26(3): 746–755. DOI:10.1007/s00167-017-4520-z
  • Carrillon Y, Abidi H, Dejour D, Fantino O, Moyen B, Tran-Minh VA. Patellar instability: Assessment on MR images by measuring the lateral trochlear inclination-initial experience. Radiology. 2000;216(2): 582–585. DOI:10.1148/radiology.216.2.r00au07582
  • Joseph SM, Cheng C, Solomito MJ, Pace JL. Lateral Trochlear Inclination Angle: Measurement via a 2-Image Technique to Reliably Characterize and Quantify Trochlear Dysplasia. Orthopaedic journal of sports medicine. 2020;8(10): 2325967120958415. DOI:10.1177/2325967120958415
  • Keser S, Savranlar A, Bayar A, Ege A, Turhan E. Is there a relationship between anterior knee pain and femoral trochlear dysplasia? Assessment of lateral trochlear inclination by magnetic resonance imaging. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2008;16(10): 911–915. DOI:10.1007/s00167-008-0571-5
  • Hochreiter B, Hirschmann MT, Amsler F, Behrend H. Highly variable tibial tubercle-trochlear groove distance (TT-TG) in osteoarthritic knees should be considered when performing TKA. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA. 2019;27(5): 1403–1409. DOI:10.1007/s00167-018-5141-x
  • Imhoff FB, Funke V, Muench LN, Sauter A, Englmaier M, Woertler K, Imhoff AB, Feucht MJ. Correction to: The complexity of bony malalignment in patellofemoral disorders: femoral and tibial torsion, trochlear dysplasia, TT-TG distance, and frontal mechanical axis correlate with each other. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2020;28(3):897-904. DOI:10.1007/s00167-019-05542-y
  • Biedert RM, Albrecht S. The patellotrochlear index: a new index for assessing patellar height. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA. 2006;14(8): 707–712. DOI:10.1007/s00167-005-0015-4
  • Harbaugh CM, Wilson NA, Sheehan FT. Correlating femoral shape with patellar kinematics in patients with patellofemoral pain. Journal of orthopaedic research: Official publication of the Orthopaedic Research Society. 2010;28(7): 865–872. DOI:10.1002/jor.21101
  • Endo Y, Schweitzer ME, Bordalo-Rodrigues M, Rokito AS, Babb JS. MRI quantitative morphologic analysis of patellofemoral region: Lack of correlation with chondromalacia patellae at surgery. AJR. American journal of roentgenology. 2007;189(5): 1165–1168. DOI:10.2214/AJR.07.2236
There are 23 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Gülşen Yücel Oğuzdoğan 0000-0002-6762-6820

Fatma Zeynep Arslan 0000-0001-6506-2577

Publication Date June 28, 2024
Submission Date April 17, 2023
Published in Issue Year 2024 Volume: 14 Issue: 2

Cite

APA Yücel Oğuzdoğan, G., & Arslan, F. Z. (2024). A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle is Associated with Greater Trochlear Sulcus Angle. Clinical and Experimental Health Sciences, 14(2), 531-537. https://doi.org/10.33808/clinexphealthsci.1284587
AMA Yücel Oğuzdoğan G, Arslan FZ. A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle is Associated with Greater Trochlear Sulcus Angle. Clinical and Experimental Health Sciences. June 2024;14(2):531-537. doi:10.33808/clinexphealthsci.1284587
Chicago Yücel Oğuzdoğan, Gülşen, and Fatma Zeynep Arslan. “A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle Is Associated With Greater Trochlear Sulcus Angle”. Clinical and Experimental Health Sciences 14, no. 2 (June 2024): 531-37. https://doi.org/10.33808/clinexphealthsci.1284587.
EndNote Yücel Oğuzdoğan G, Arslan FZ (June 1, 2024) A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle is Associated with Greater Trochlear Sulcus Angle. Clinical and Experimental Health Sciences 14 2 531–537.
IEEE G. Yücel Oğuzdoğan and F. Z. Arslan, “A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle is Associated with Greater Trochlear Sulcus Angle”, Clinical and Experimental Health Sciences, vol. 14, no. 2, pp. 531–537, 2024, doi: 10.33808/clinexphealthsci.1284587.
ISNAD Yücel Oğuzdoğan, Gülşen - Arslan, Fatma Zeynep. “A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle Is Associated With Greater Trochlear Sulcus Angle”. Clinical and Experimental Health Sciences 14/2 (June 2024), 531-537. https://doi.org/10.33808/clinexphealthsci.1284587.
JAMA Yücel Oğuzdoğan G, Arslan FZ. A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle is Associated with Greater Trochlear Sulcus Angle. Clinical and Experimental Health Sciences. 2024;14:531–537.
MLA Yücel Oğuzdoğan, Gülşen and Fatma Zeynep Arslan. “A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle Is Associated With Greater Trochlear Sulcus Angle”. Clinical and Experimental Health Sciences, vol. 14, no. 2, 2024, pp. 531-7, doi:10.33808/clinexphealthsci.1284587.
Vancouver Yücel Oğuzdoğan G, Arslan FZ. A New Perspective to Assess Patellar Surface-Trochlear Sulcus Compatibility: Narrowed Patellar Angle is Associated with Greater Trochlear Sulcus Angle. Clinical and Experimental Health Sciences. 2024;14(2):531-7.

14639   14640