MRI-based analysis of patellofemoral cartilage contact, thickness, and alignment in extension, and during moderate and deep flexion

Abstract

Background Several factors are believed to contribute to patellofemoral joint function throughout knee flexion including patellofemoral (PF) kinematics, contact, and bone morphology. However, data evaluating the PF joint in this highly flexed state have been limited. Therefore, the purpose of this study was to evaluate patellofemoral contact and alignment in low (0°), moderate (60°), and deep (140°) knee flexion, and then correlate these parameters to each other, as well as to femoral morphology. Materials and Methods Sagittal magnetic resonance images were acquired on 14 healthy female adult knees (RSRB approved) using a 1.5T scanner with the knee in full extension, mid-flexion, and deep flexion. The patellofemoral cartilage contact area, lateral contact displacement (LCD), cartilage thickness, and lateral patellar displacement (LPD) throughout flexion were defined. Intra- and inter-rater repeatability measures were determined. Correlations between patellofemoral contact parameters, alignment, and sulcus morphology were calculated. Results Measurement repeatability ICCs ranged from 0.94–0.99. Patellofemoral cartilage contact area and thickness, LCD, and LPD were statistically different throughout all levels of flexion (p<0.001). The cartilage contact area was correlated to LPD, cartilage thickness, sulcus angle, and epicondylar width (r=0.47–0.72, p<0.05). Discussion This study provides a comprehensive analysis of the patellofemoral joint throughout flexion throughout its range of motion. Conclusions This study agrees with past studies that investigated patellofemoral measures at a single flexion angle, and provides new insights into the relationship between patellofemoral contact and alignment at multiple flexion angles.

MR görüntüleme kullanarak troklear morfoloji ve lateral patellar kartilaj defekti arasındaki ilişki

“…Patellar cartilage defects may develop as a result of patellofemoral morphological variations or anatomical incompatibility. Therefore, evaluation of the morphological properties of the patellofemoral joint plays an important role in the diagnosis of chondromalacia patella [3,5,11,[16][17][18][19].…”

“…Increased SA is a risk factor for LPCD in both sexes. Shallow femoral trochlea can lead to patellar instability and disproportional load distribution on the articular surface of the patellofemoral joint during knee movement [15,17,19].…”

“…When the lateral facet is flattened, the patella is more likely to be laterally displaced. Thus, the contact between the patella and lateral femoral condyle increases, leading to cartilage damage in the patellofemoral joint [1,15,17,19,20].…”

Distalization and Medialization of Tibial Tuberosity for the Treatment of Potential Patellar Instability with Patella Alta

“…Lateral patellar displacement was defined as the medial/lateral distance between the most posterior point on the patella in the mid-patellar axial image and the deepest point in the sulcus at the axial level of the femoral epicondylar width. 16 …”

Biomaterials to Mimic and Heal Connective Tissues

“…Macroscale tissue structure is commonly evaluated with MRI, xray, and ultrasound. Several MRI pulse sequences (T 1 , T 2 ) can define anatomical features of body tissues that depend on water content (e.g., bone, cartilage, tendon, fat) [119] and infer glycosaminoglycan distributions in tissues such as cartilage (T 2* , T 1ρ ). [120,121] Ultrasound can monitor soft tissue structures with low acoustic impedance, such as fetuses, abdominal features, and tendons.…”