Evaluation of patellar tendon morphology in Turkish population: a cross-sectional study

Yıl 2023, Cilt: 6 Sayı: 3, 650 - 655, 31.05.2023

Ali Köksal , Berin Tuğtağ Demir , Fatih Çankal

https://doi.org/10.32322/jhsm.1279829

Öz

Aim: This study aims to investigate the length, width and thickness of the patellar tendon and the type and length of the patella with MRI and to reveal the normal values ​​of patellar tendon morphology specific to the Turkish population.
Material and Method: The study was conducted with 348 individuals (137 males, 211 females) who applied to our hospital, had no anterior knee pathology, and had knee MRIs. The length, proximal and distal width and thickness of the patellar tendon, patella type, prepatellar and infrapatellar fat pad signal characteristics and Insall-Salvati ratio were evaluated on knee MRI images of these individuals.
Results: Type I patella was detected in 23.9%, type II in 57.2%, type III in 16.1%, and type IV in 2.9% of individuals. The mean length of the patella was 41.26±4.36 mm, the patellar tendon length was 47.36±6.70 mm, the proximal width was 28.86±3.49 mm, the distal width was 23.53±2.69 mm, the proximal thickness was 3,62±1.47 mm, and distal thickness was 5.21±1.1 mm. It was determined that the Insall-Salvati ratio did not cause a statistical difference according to age, but the patella type showed significance with the Insall-Salvati classification.
Conclusion: While evaluating MRI images, the effect of social differences on measurements should not be ignored; normal measurement values ​​of the tendon should be known to evaluate pathological measurements.

Anahtar Kelimeler

Patellar tendon, Patella type, Insall-Salvati ratio

Proje Numarası

YOK

Kaynakça

• DeFrate LE, Nha KW, Papannagari R, Moses JM, Gill TJ, Li G. The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion. J Biomech 2007; 40:1716–22.
• 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: 721-7.
• Erickson BJ, Harris JD, Fillingham YA, et al. Anterior cruciate ligament reconstruction practice patterns by NFL and NCAA football team physicians. Arthroscopy 2014; 30: 731-8.
• Widjajahakim R, Roux M, Jarraya M, 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.
• Çankal F, Patat D, Kaya M, Gürün E. Magnetic resonance appearance and clinical significance of anterior suprapatellar fat pad in anterior knee pain. Lokman Hekim Health Sci 2022; 2: 117–23.
• Yang B, Tan H, Yang L, Dai G, Guo B. Correlating anatomy and congruence of the patellofemoral joint with cartilage lesions. Orthopedics 2009; 32: 20
• Jibri Z, Martin D, Mansour R, Kamath S. The association of infrapatellar fat pad oedema with maltracking: A casecontrol study. Skeletal Radiol 2012; 41: 925-31.
• Shabshin N, Schweitzer ME, Morrison WB. Quadriceps fat pad edema: significance on magnetic resonance images of the knee. Skeletal Radiol 2006; 35: 269–74
• Shaffer B, Gow W, Tibone JE. Graft-tunnel mismatch in endoscopic anterior cruciate ligament reconstruction: a new technique of intraarticular measurement and modified graft harvesting. Arthroscopy 1993; 9: 633-46.
• Spindler KP, Bergfeld JA, Andrish JT. Intraoperative complications of ACL surgery: avoidance and management. Orthopedics 1993; 16: 425-30.
• Verma NN, Dennis MG, Carreira DS, Bojchuk J, Hayden JK, Bach JBR. Preliminary clinical results of two techniques for addressing graft tunnel mismatch in endoscopic anterior cruciate ligament reconstruction. J Knee Surg 2005; 18: 183-91.
• Hansen P, Bojsen-Moller J, Aagaard P, Kjaer M, Magnusson SP. Mechanical properties of the human patellar tendon, in vivo. Clin Biomech 2006; 21:54–8.
• Chang BC, Seong SC, Kim TK. Preoperative magnetic resonance assessment of patellar tendon dimension for graft selection in anterior cruciate ligament reconstruction. Am J Sports Med 2009; 37: 376–82.
• Wiberg G. Roentgenographic and anatomic studies on the femoropatellar joint. Acta Orthop Scand 1941; 12: 319–410.
• Baumgartl F. Das Kniegelenk: Berlin, Springer-Verlag, 1964
• Miller TT, Staron RB, Feldman F. Patellar height on sagittal MR imaging of the knee. AJR 1996; 167: 339-41.
• Basso O, Johnson DP, Amis AA. The anatomy of the patellar tendon. Knee Surg Sports Traumatol Arthrosc 2001; 9: 2-5
• Peace KA, Lee JC, Healy J. Imaging the infrapatellar tendon in the elite athlete. Clin Radiol 2006; 61: 570–8.
• Uçucu O. Patellar tendonun boyutlarinin manyetik rezonans görüntüleme ile değerlendirilmesi. Uzmanlik Tezi, Kırıkkale Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı, Kırıkkale; 2011
• 20. Fredberg U, Bolvig L, Andersen NT, Stengaard-Pedersen K. Ultrasonography in evaluation of achilles and patella tendon thickness. Ultraschall in Med 2008; 29: 60-5.
• Andrikoula S, Tokis A, Vasiliadis HS, Georgoulis A. The extensor mechanism of the knee joint: an anatomical study. Knee Surg Sports Traumatol Arthrosc 2006; 14: 214-20.
• Svensson M, Kartus J, Ejerhed L, Lindahl S, Karlsson J. Does the patellar tendon normalize after harvesting its central third? A prospective long-term MRI study. Am J Sports Med 2004; 32: 34-8.
• Arslan E, Acar T, Adıbelli ZH. Türk toplumunda patellar kondromalazi: Prevalansı ve patella tipleri ile olan ilişkisi. Tepecik Eğit ve Araşt Hast Derg 2018; 28: 83-8.
• Demirağ B, Kaplan T, Köseoğlu E. Türk toplumundaki erişkinlerde patella tiplerinin dağılımı. Uludağ Üni. Tıp Fak. Derg 2004; 30: 71-4.
• Simmons E, Cameron JC. Patella alta and recurrent dislocation of the patella. Clin Orthop Relat Res 1992; 274: 265-9.
• Luyckx T, Didden K, Vandenneucker H, Labey L, Innocenti B, Bellemans J. Is there a biomechanical explanation for anterior knee pain in patients with patella alta Influence of patellar height on patellofemoral contact force, contact area and contact pressure. J Bone Joint Surg Br 2009; 91: 344-50
• Subhawong TK, Eng J, Carrino JA, Chhabra A. Superolateral Hoffa’s fat pad edema: Association with patellofemoral maltracking and impingement. AJR Am J Roentgenol 2010; 195: 1367-73
• Kalichman L, Zhang Y, Niu J, et al. The association between patellar alignment and patellofemoral joint osteoarthritis features—an MRI study. Rheumatology (Oxford) 2007; 46: 1303-1308.
• Ergün T. Asemptomatik bireylerde yaş ve cinsiyete bağlı patellofemoral morfolojideki farklılıkların analizi: manyetik rezonans görüntüleme çalışması. F.Ü. Sağ.Bil. Tıp. Derg 2019; 33: 31-7.
• National Joint Registry for England and Wales: 1st Annual Report September 2004. www.njrcentre.org.uk.(accessible date: 01.04.2023).