The association of patellar maltracking with infrapatellar fat pad edema and chondromalacia patella: A quantitative morphological magnetic resonance imaging analysis

Abstract

Objectives: This study aims to investigate the relationship of patellofemoral joint morphology with infrapatellar fat pad edema and chondromalacia patella (CP) using patellar maltracking parameters on magnetic resonance imaging (MRI). Patients and methods: Between January 2010 and January 2013, 50 patients with edema in the superolateral portion of the infrapatellar fat pad (the study group) and control group (n=50) with a normal infrapatellar fat pad were identified on MRI to compare with regard to five patellar maltracking parameters retrospectively. These parameters were trochlear depth, the trochlear sulcus angle (TSA), patellar translation, the lateral patellofemoral angle (PFA), and the Insall-Salvati ratio. The relationship between patellar maltracking and the CP was also evaluated using the same parameters. Results: In the study group, the Insall-Salvati index and TSA were significantly higher (p=0.001), and the trochlear depth and PFA were low (p=0.001, p=0.01), while patellar translation showed no difference (p=0.957). In the CP group, the Insall-Salvati index and TSA were significantly high (p=0.001), the trochlear depth was low (p=0.001). No statistically significant difference was found in PFA and patellar translation (p=0.292, p=0.446). Conclusion: Our study results suggest that edema in the superolateral portion of infrapatellar fat pad and CP are associated with patellar maltracking.

Relationship between patellar tendon–lateral femoral condyle friction syndrome and patellofemoral instability

“…We be- Chondromalacia patella is characterized by damage to the knee joint cartilage and leads to instability. In their study, Gürsoy et al reported that the patellar shift in patients with chondromalacia patella and lateral patellofemoral angles was similar to that in patients without chondromalacia patella, whereas trochlear depth was shorter, sulcus angle was wider, and the Insall-Salvati ratio was higher [12]. In the present study, it was found that the prevalence of PTLFCFS increased in patients with chondromalacia patella.…”

“…Matcuk et al and Subhawong et al described that the sulcus angles of patients with PTLFCFS were similar to those of the control group [3,7]. However, Gürsoy et al reported that the sulcus angle was significantly higher in the PTLFCFS group compared with the control group [12]. Widjajahakim et al reported that superolateral Hoffa fat pad edema was not associated with the sulcus angle [9].…”

“…Matcuk et al reported that the lateral trochlear inclination angle was lower in patients with PTLFCFS and that angles <11° were associated with high risk[3].Li et al found that the lateral trochlear inclination angle was low in patients with PTLFCFS and that sensitivity and specificity were 98.9% and 32%, respectively, for a cut-off value of 16.3[1]. Gürsoy et al found a decrease in the lateral patellofemoral angle[12]. Barbier-Brion et al found that the lateral trochlear inclination angle was similar between the patient and control groups[4].…”

Effects of Insall-Salvati ratio and obesity on suprapatellar fat pad

“…In another similar study, a positive correlation was found between ACL tears and patella baja (11). Gursoy et al reported a significant relationship between infrapatellar fat pad edema and chondromalacia patella with patellar maltracking (12). Similarly, Jibri et al demonstrated Şirik, İnan that edema in the superolateral portion of Hoffa's fat pad was associated with patellar maltracking (13).…”

Increased signal intensity, not volume variation of infrapatellar fat pad in knee osteoarthritis: A cross-sectional study based on high-resolution magnetic resonance imaging

“…13 IPFP resection will lead to decreased tibial external rotation, an increase of patellar flexion, and a medialization of the patella. 34 Meanwhile, IPFP edema will influence the patellar maltracking, 27,[35][36][37] indicating the knee malalignment after the change of IPFP volume. In this study, IPFP maximal area showed a significantly positive association with ISR (Table 3).…”