The association of patellar tendinosis with patellar maltracking and Hoffa’s fat pad impingement: A case-control MRI study

Delorme, Jean-Philippe; Jibri, Zaid

doi:10.1016/j.clinimag.2021.04.011

Cited by 5 publications

(5 citation statements)

References 45 publications

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“… 12 Furthermore, Delorme et al have suggested a relationship between proximal patellar tendinosis and patellar maltracking parameters including Hoffa’s fat pad impingement. 13 This finding is described in this case, depicting a small high signal focus at the inferior pole of the patella, likely reflecting very early tendinosis at the origin of the medial bundle of the crossed-doubled PT.…”

Section: Discussionsupporting

confidence: 53%

A rare cause of Hoffa’s fat pad impingement: the crossed-doubled patellar tendon

Munday,

Patel,

Jain

et al. 2023

BJR|case reports

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Section: Discussionsupporting

confidence: 53%

A rare cause of Hoffa’s fat pad impingement: the crossed-doubled patellar tendon

Munday,

Patel,

Jain

et al. 2023

BJR|case reports

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“…In our study, the lateral trochlear inclination was significantly lower in SHFPE and PFPE patients, meaning that a lower lateral trochlear inclination might lead to patellar maltracking and impinged IFP or PFP. Current studies [ 7 , 11 , 12 , 27 ] have debated the relationship between SHFPE and trochlear morphology; however, most of them [ 12 ] did not mention if cartilage surface was included when measuring trochlear morphology, and they used different measurement planes such as 3 cm above the joint [ 11 ] or the most posterior condyle plane [ 7 ]. According to our experience, the trochlear morphology measurement should be along the osseous surface rather than the cartilage surface to decrease the effect of cartilage lesions, and the most posterior condyle plane was more convenient to measure and compare to the plane 3 cm above the joint.…”

Section: Discussionmentioning

confidence: 99%

“…We carefully selected several patellofemoral maltracking parameters after reviewing previous studies [ 7 , 11 , 15 – 17 ], including lateralization of the tibial tubercle (TT-TG [tibial tuberosity-trochlear groove]) distance and TT-TG index, trochlear morphology (trochlear depth, lateral trochlear inclination angle), and patellar parameters (patella alta, patellar tilt angle, and bisect offset). Two board-certified radiologists measured these parameters (27 and 7 years of experience in musculoskeletal MRI, respectively) in both case and control groups.…”

Section: Methodsmentioning

confidence: 99%

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Association among peripatellar fat pad edema and related patellofemoral maltracking parameters: a case-control magnetic resonance imaging study

Lyu,

Li,

Zhong

et al. 2023

BMC Musculoskelet Disord

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Background The peripatellar fat pads are critical for protective cushioning during movement, and their endocrine function has been shown to affect osteoarthritis. Magnetic resonance imaging (MRI) is frequently used to visualize edema of the peripatellar fat pads due to injury. In this study, we aimed to assess the relationship between peripatellar fat pad edema and patellofemoral maltracking MRI parameters and investigate the association among cases of peripatellar fat pad edema. Methods Age- and sex-matched peripatellar fat pad edema cases were identified and divided into superolateral Hoffa, quadriceps, and prefemoral groups. Images were assessed according to tibial tuberosity lateralization, trochlear dysplasia, patellar alta, patellar tilt, and bisect offset. McNemar’s test or paired t-tests and Spearman’s correlation were used for statistical analysis. Interobserver agreement was assessed with the intraclass correlation coefficient. Results Of 1210 MRI scans, 50, 68, and 42 cases were in the superolateral Hoffa, quadriceps, and prefemoral groups, respectively. Subjects with superolateral Hoffa fat pad edema had a lower lateral trochlear inclination (p = 0.028), higher Insall-Salvati (p < 0.001) and modified Insall-Salvati (p = 0.021) ratios, and lower patellotrochlear index (p < 0.001) than controls. The prefemoral group had a lower lateral trochlear inclination (p = 0.014) and higher Insall-Salvati (p < 0.001) and modified Insall-Salvati (p = 0.004) ratios compared with the control group. In contrast, the patellotrochlear index (p = 0.001) was lower. Mean patellar tilt angle (p = 0.019) and mean bisect offset (p = 0.005) were significantly different between cases and controls. The quadriceps group showed no association. Superolateral Hoffa was positively correlated with prefemoral (p < 0.001, r = 0.408) and negatively correlated with quadriceps (p < 0.001, r = -0.500) fat pad edema. Conclusions Superolateral Hoffa and prefemoral fat pad edemas were associated with patellar maltracking parameters. Quadriceps fat pad edema and maltracking parameters were not associated. Superolateral Hoffa fat pad edema was positively correlated with prefemoral and negatively correlated with quadriceps fat pad edema.

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“…An animal study has shown histopathological changes in the fat pad with increased cellularity and vascularity in a rat model of patellar tendinopathy [ 135 ]. Case-control studies have shown that Hoffa's fat pad impingement was associated with proximal patellar tendinopathy [ 136 ] and quadriceps fat pad edema was associated with increased quadriceps tendon alterations and quadriceps tendon thickness in patients [ 137 ]. The Kager fat pad underwent significant deformation during plantar flexion in a cadaveric ankle study, suggesting that it acts as a shock absorber to the Achilles tendon and pathological changes to the fat pad may be clinically important in the development of Achilles tendinopathy [ 138 ].…”

Section: Common Inflammatory Mediators Linking Obesity and Tendinopathymentioning

confidence: 99%

Inflammatory mechanisms linking obesity and tendinopathy

Lui

Yung

2021

Journal of Orthopaedic Translation

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Chronic tendinopathy is a debilitating tendon disorder with disappointing treatment outcomes. This review focuses on the potential roles of chronic low-grade inflammation in promoting tendinopathy in obesity. A systematic literature search was performed to identify all clinical studies supporting the actions of obesity-associated inflammatory mediators in the development of tendinopathy. The mechanisms of obesity-induced chronic inflammation in adipose tissue are firstly reviewed. Common inflammatory mediators potentially linking obesity and the development of tendinopathy, and their association with mechanical overuse, are discussed, along with pre-clinical evidences and a systematic literature search on clinical studies. The potential contribution of local adipose tissues in the promotion of inflammation, pain and tendon degeneration is then discussed. The future research directions are proposed. Translational potential statement Better understanding of the roles of obesity-associated inflammatory mediators on tendons will clarify the pathophysiological drivers of tendinopathy in patients with obesity and identify possible treatment targets. Further studies on the mechanisms of obesity-induced chronic inflammation on tendon are a promising direction for the treatment of tendinopathy.

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The association of patellar tendinosis with patellar maltracking and Hoffa’s fat pad impingement: A case-control MRI study

Cited by 5 publications

References 45 publications

A rare cause of Hoffa’s fat pad impingement: the crossed-doubled patellar tendon

A rare cause of Hoffa’s fat pad impingement: the crossed-doubled patellar tendon

Association among peripatellar fat pad edema and related patellofemoral maltracking parameters: a case-control magnetic resonance imaging study

Inflammatory mechanisms linking obesity and tendinopathy

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