Chondromalacia Patella among Military Recruits with Anterior Knee Pain: Prevalence and Association with Patellofemoral Malalignment

Abstract

Background:The aim of this study was to investigate the frequency of chondromalacia patella (CMP) and to evaluate its relation with trochlear morphometric and patellofemoral alignment measurements as well as with edema in superolateral region of Hoffa's fat pad (SHFP) in military recruits with anterior knee pain (AKP).Materials and Methods:Knee magnetic resonance imaging examinations of 288 military recruits with AKP were retrospectively evaluated. Patellar cartilage lesions were graded using modified Noyes system. Quantitative measurements of trochlear morphology (sulcus angle, trochlear sulcus depth, and lateral trochlear inclination [LTI]) and patellofemoral alignment (patellar translation [PT], lateral patellofemoral angle (LPA), Insall-Salvati index, and tibial tuberosity-trochlear groove distance) were made. The SHFP region was assessed for the presence of edema. Mean values of measurements in knees with and without CMP and in knees with early and advanced stage CMP were compared.Results:We found CMP in 169 (58.7%) patients. Patients with CMP demonstrated a significantly greater sulcus angle (P = 0.012), smaller LTI (P = 0.004), greater PT (P = 0.01), smaller LPA (P = 0.036), greater Insall-Salvati ratio (P = 0.034), and higher incidence of SHFP edema (P = 0.001) compared to those without CMP. While none of the measurements were associated with the severity of cartilage damage, the incidence of SHFP edema was significantly correlated with the severity of CMP (P = 0.001).Conclusion:CMP is a common disorder among military recruits with AKP. Patellofemoral malalignment is an important contributory factor in the development of CMP, and the presence of edema in SHFP may be a strong indicator of underlying severe CMP in this population.

Evaluation of Anterior Knee Pain by Magnetic Resonance Imaging

“…We also found that trochlear dysplasia and patellofemoral malalignment were commonly associated (56.25%) with CP. This agreed with findings of Özdemir and Kavak (18) who reported that patellofemoral malalignment is an important predisposing factor in the development of chondromalacia patella. Thus, we recommend MRI technique in evaluation and diagnosis of different pathologies and risk factors causing AKP as it is the best available, safe and accurate technique.…”

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

“…There is plenty of research work done on trochlear morphology and PF pathology with contrasting results. 23 24 25 26 27 The three-dimensional shape of the femoral trochlea is becoming the center of consideration in determining CMP. According to Ali et al, the trochlear morphology plays a key role in PF pathology and should always be taken into account while taking PF parameters.…”

Condromalácia patelar - aspectos etiológicos, epidemiológicos e manejo terapêutico / Chondromalacia patellae - etiology, epidemiology and therapeutic management

“…A principal queixa da CMP é dor na porção anterior da articulação patelofemoral, acompanhada com crepitações, que são referidas pelos pacientes como a presença de "areia nos joelhos". Esse desconforto articular exacerba-se em situações que aumentam o estresse mecânico nos joelhos, principalmente em exercícios de impacto (OZDEMIR; KAVAK, 2019;HABUSTA et al, 2021) KRIEGER et al, 2020;TABARY et al 2020;ZHENG et al, 2021).…”