Kondromalazi patella ve patella tiplerinin morfometrik analizi

Abstract

Amaç: Bu çalışma, Türk toplumunda patella tiplerini, kondromalazi patella bulgusunu belirlemek, cinsiyet ve yaş grupları arasındaki farklılıkları Manyetik Rezonans Görüntüleme (MRG) ile değerlendirmek amacıyla yapıldı. Yöntem: Retrospektif olarak tasarlanan çalışmaya, Ocak 2015 ve Aralık 2017 tarihleri arasında Kozan Devlet Hastanesi Ortopedi Kliniğine diz eklemlerinde çeşitli şikayetler ve farklı ön tanılarla başvuran 18-81 yaş arası 256 kişi (122 kadın, 134 erkek) dahil edildi. Çalışmada değerlendirmeler MR görüntüleri üzerinde yapılmıştır. Çalışmamızda patella tiplerini, kondromalazi sınıflandırmasını, yaş ve cinsiyete göre karşılaştırmasını değerlendirdik. Bulgular: Patella tipleri cinsiyetler arasında anlamlı düzeyde farklılık göstermedi; ancak kondromalazi patellada cinsiyetler arasında anlamlı farklılık saptandı (p=0,03). Patella tipleri sınıflandırılarak Tip II Patella'nın en sık görülen patella tipi olduğu, Tip IV'ün ise en az görülen patella tipi olduğu belirlendi. Sonuç: Çalışmamızda elde edilen verilerin anatomi, radyoloji ve ortopedi alanlarında patellanın morfometrisinin anlaşılmasında faydalı olacağına inanıyoruz. Bulgularımıza dayanarak patellanın anatomik şeklinin patellofemoral bölgedeki defektlerin gelişimini yansıtabilecek önemli bir anatomik parametre olduğu sonucuna vardık. Ayrıca yaşlanma sürecinde diz patolojilerinin daha net tanımlanması açısından klinik olarak da önemli olduğu ve toplumlar arasındaki farklılıkları ve patellayı içeren birçok patolojiyi ortaya koyuyor.

Keywords

• Kondromalazi Patella
• Diz
• Morfometri
• Patella türleri

Morphometric analysis of chondromalacia patella and patella types

Abstract

Aims: The present study was conducted to determine patella types, chondromalacia patella finding in the Turkish society, and to evaluate the differences between gender and age groups to with Magnetic Resonance Imaging (MRI). Methods: The study had a retrospective design, and included 256 people (122 females, 134 male) who were between the ages of 18 and 81 admitting to the Orthopedic Clinic of Kozan State Hospital with various complaints in knee joints and different preliminary diagnoses between January 2015 and December 2017. The evaluations made on MR images in the study. We evaluated in our study were patella types, chondromalacia classification and comparison according to age and gender. Results: Patella types did not differ between the genders at significant levels; however, significant differences were detected between the genders in the chondromalacia patella (p=0.03). Patella types were classified, and it was found that Type II Patella was the most common patella type, and Type IV was identified as the least common. Conclusion: We believe that the data obtained in our study will be useful in understanding morphometry of patella in anatomy, radiology and orthopedics fields. Based on our findings, we concluded that the anatomical shape of the patella is an important anatomic parameter, which may reflect the development of defects in the patellofemoral region It is also clinically important in terms of identifying knee pathologies more clearly in the aging process, and revealing the differences between societies, and in many pathologies that involve patella.

Keywords

• Chondromalacia patella
• knee
• morphometry
• patella types

References

1. Simonaitytė R, Rutkauskas S, Čekanauskas E, et al. First-time acute lateral patellar dislocation in children and adolescents: what about unaffected knee patellofemoral joint anatomic abnormalities? Medicina. 2021;57(3):206.
2. Yu Z, Yao J, Wang X, et al. Research methods and progress of patellofemoral joint kinematics: a review. J Healthc Eng. 2019;9159267. doi:10.1155/2019/9159267
3. Yang B, Tan H, Yang L, et al. Correlating anatomy and congruence of the patellofemoral joint with cartilage lesions. Orthopedics. 2019;32(1):20.
4. Zheng W, Li H, Hu K, et al. Chondromalacia patellae: current options and emerging cell therapies. Stem Cell Res Ther. 2021;12(1):412. doi:10.1186/s13287-021-02478-4
5. 5. Aktaş B, Komut E, Kültür T, et al. Patellar tendon yüksekliklerinin (patella alta ve patella baja) patella kondromalazisi ile ilişkisi. KÜ Tıp Fak Derg. 2015;17(2):1-8.
6. Cao L, Sun K, Yang H, et al. Influence of patellar morphology classified by Wiberg classification on knee joint function and patellofemoral tracking after total knee arthroplasty without patellar resurfacing. J Arthroplasty. 2021;36(9):3148-3153.
7. Dursun M, Ozsahın M, Altun G. Prevalence of chondromalacia patella according to patella type and patellofemoral geometry: a retrospective study. Sao Paulo Med J. 2022;140(6):755-761. doi: 10.1590/1516-3180.2021.0206.R2.10012022
8. Arslan E, Acar T, Adıbelli H. Patellar chondromalacia in Turkish population: its prevalence and relationship with patella types. J Tepecik Edu Res Hosp. 2018;28(2):83-88.

9. Hayirlioglu A, Doganay H, Yilmabasar MG, et al. The evaluation of the association between patella types and chondromalacia patella by magnetic resonance imaging. Int J Diagnostic Imaging. 2015;2(2):21-28.
10. Yao l, Gentili A, Thomas A. Incidental magnetizasyon transfer contrast in fast spin- echoimaging of cartilage. J Magn Reson Imaging. 1996;6(1):180-184.
11. Slattery C, Kweon CY. Classifications in brief: outerbridge classification of chondral lesions. Clin Orthop Relat Res. 2018;476(10):2101-2104.
12. Kim HJ, Cho J, Lee S. Talonavicular joint mobilization and foot core strengthening in patellofemoral pain syndrome: a single-blind, three-armed randomized controlled trial. BMC Musculoskelet Disord. 2022;23(1):150. doi:10.1186/s12891-022-05099-x
13. Wheatley M, Rainbow MJ, Clouthier AL. Patellofemoral mechanics: a review of pathomechanics and research approaches. Curr Rev Musculoskelet Med. 2020;13(3):326-337.
14. Reider B, Marshall JL, Koslin B. The anterior aspect of the knee joint an anatomic study. J Bone Joint Surg. 1981;63(3):351-356.
15. Atbaşı Z, Parlak A, Aytekin A, et al. Genç erkek erişkinlerde ön diz ağrısının kondromalezi patella Q açısı ve patella tipleri ile ilişkisi. Gülhane Tıp Derg. 2013;55(2):89-93. doi:10.5455/gulhane.39853
16. Kaplan T, Başar H, İnanmaz ME. Sakarya ilindeki erişkinlerde patella tiplerinin dağılımı. Sakarya Med J. 2014;4(3):125-128. doi: 10.5505/sakaryamj
17. Demirağ B, Kaplan T, Köseoğlu E. Türk toplumundaki erişkinlerde patella tiplerinin dağılımı. Uludağ Üni Tıp Fak Derg. 2004;30(2):71-74.
18. 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. 2018;54(2):21.
19. Rahman S, Ahmed Shokri A, Ahmad MR, et al. Intraoperative patella dimension measurement in Asian female patients and its relevance in patellar resurfacing in TKA. Advances Orthop. 2020:4539792. doi: doi.org/10.1155/2020/4539792
20. Demir M, Şahan MH. Evaluation of the relationship between trochlear and patellar morphology and patellar chondromalacia with magnetic resonance imaging. Acta Orthop Belg. 2023;89(3):409-416. doi:10.52628/89.3.11782
21. Mehl J, Feucht MJ, Bode G, et al. 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(3):838-846.
22. Sirik M, Uludag A. Assessment of the relationship between patellar volume and chondromalacia patellae using knee magnetic resonance imaging. North Clin Istanb. 2019;7(3):280-283. doi:10.14744/nci.2019.65882
23. Fithian DC, Paxton EW, Stone ML, et al. Epidemiology and natural history of acute patellar dislocation. Am J Sports Med. 2004;32(5):1114-1121.
24. Dai Y, Yin H, Xu C, et al. Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis. J Orthop Surg Res. 2021;16(1):548. doi.org/10.1186/s13018-021-02681-2