The influence of isolated femur and tibia rotations on patella cartilage stress: a sensitivity analysis

Liao, Tzu‐Chieh; Li, Yin; Powers, Christopher M.

doi:10.1016/j.clinbiomech.2018.03.003

Cited by 29 publications

(25 citation statements)

References 36 publications

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“…Apart from the shape of the trochlear groove, our results suggest the significance of a longer lateral condyle in the anterior‐posterior direction (trochlea – mode 3). This feature has not been previously reported to be associated with PFJ pathology; nevertheless, we speculate that a longer lateral condyle may influence TFJ kinematics, which again, leads to changes in PFJ stress 45,46 . Taken together, our results confirm that trochlear shape, such as a shallow groove, is associated with the presence of PFJ OA.…”

Section: Discussionsupporting

confidence: 81%

Longitudinal analysis of the contribution of 3D patella and trochlear bone shape on patellofemoral joint osteoarthritic features

Liao

Jergas

Tibrewala

et al. 2020

Journal Orthopaedic Research

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To explore bone shape features that are associated with patellofemoral joint (PFJ) osteoarthritic features. Thirty subjects with PFJ degeneration (six males, 53.2 ± 9.8 years) and 23 controls (12 males, 48.1 ± 10.6 years) were included. Magnetic resonance (MR) assessment was performed to provide bone segmentation, morpholgocial grading, and cartilage relaxation times. In addition, subject self‐reported symptoms were reported. Logistic regressions were used to identify the shape features that were associated with the presence and worsening of PFJ morphological lesions over 3 years, and worsening of self‐reported symptoms. Statistical parametric mapping was used to evaluate the associations between shape features and cartilage relaxation times at 3 years. Results indicated that subjects with PFJ degeneration exhibited a trochlea with longer lateral condyle and shallower trochlear groove (adjusted odds ratio [OR] = 0.30; 95% confidence interval [CI]: 0.10, 0.86; P = .025). Subjects with worsening of PFJ degeneration exhibited a patella with equally distributed facets (adjusted OR = 3.14; 95% CI: 1.05, 9.37; P = .040) and lateral bump (adjusted OR = 0.14; 95% CI: 0.02, 0.83; P = .030). No shape features were associated with worsening of self‐reported symptoms. Elevated T1ρ and T2 times at 3 years were associated with a patella with a lateral hook, equally distributed facets, round and thick as well as a trochlea larger in size (R = 0.38~0.46, P = .015~.025). The study demonstrated the ability of 3D statistical shape modeling to quantify patella and trochlear bone shape features that are associated with the presence and progression of PFJ osteoarthritic features.

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Section: Discussionsupporting

confidence: 81%

Longitudinal analysis of the contribution of 3D patella and trochlear bone shape on patellofemoral joint osteoarthritic features

Liao

Jergas

Tibrewala

et al. 2020

Journal Orthopaedic Research

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“…Nevertheless, the location coincides with conditions that share similar etiology, such as patellofemoral pain and primary PFJ OA, where the lateral compartment is more commonly affected. 8,20,21,28 A commonly cited hypothesis to the cause of patellofemoral pain and PFJ OA is elevated PFJ joint stress secondary to decreased utilized contact area. 19 Even though PFJ stress and contact area were not assessed, we can speculate that these events, with altered patellar alignment, occur as sequelae of ACLR.…”

Section: Discussionmentioning

confidence: 99%

Patellar Malalignment Is Associated With Patellofemoral Lesions and Cartilage Relaxation Times After Hamstring Autograft Anterior Cruciate Ligament Reconstruction

et al. 2020

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Background: There is growing evidence suggesting a link between patellofemoral joint (PFJ) osteoarthritis in anterior cruciate ligament (ACL)–reconstructed knees and altered joint alignment. Purpose: To determine whether patellar alignment differs between participants with and without ACL reconstruction (ACLR) and to identify possible associations between patellar alignment and PFJ osteoarthritis features over 3 years. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 37 participants with ACLR (sex, 23 male; mean ± SD age, 28.1 ± 7.4 years) and 20 healthy controls (13 male; 30.4 ± 4.8 years) participated. Patients underwent magnetic resonance imaging: (1) sagittal T2-weighted fat-saturated fast spin echo images to calculate patellar alignment, (2) sagittal 3-dimensional intermediate-weighted fast spin echo Cube sequence for clinical morphological grading (modified Whole-Organ Magnetic Resonance Imaging Score [WORMS]), and (3) sagittal combined T1ρ/T2 mapping sequence for performing voxel-based relaxometry. Patellar alignment of the ACLR knees were assessed at 6 months (baseline). One-way analysis of variance was used to compare patellar alignment among the ACLR (at 6 months), contralateral, and control knees. Within the ACLR group, a logistic regression model was used to identify if patellar alignment measures at baseline were risk factors for worsening of PFJ structural changes over 3 years. Statistical parametric mapping was used to evaluate the longitudinal associations between patellar alignment and cartilage relaxation times at 3 years. Results: When compared with control knees, ACLR knees exhibited a laterally and anteriorly displaced patella ( P = .045 and P = .041), less flexion ( P = .031), and less lateral spin ( P = .012). Furthermore, excessive lateral displacement was a significant predictor of worsening of WORMS ( P = .050). Lateral displacement was positively correlated with increased T1ρ and T2 in the patellar and trochlear cartilage at 3 years. Patellar lateral spin revealed similar negative findings. Conclusion: Participants with ACLR exhibited a laterally and anteriorly displaced patella, less flexion, and less lateral spin when compared with healthy controls. Excessive patellar lateral displacement was the strongest predictor to the development of PFJ osteoarthritis features longitudinally.

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“…7 Furthermore, the correlation between tibial structural abnormalities and patellar cartilage stress, but not cartilage defects, was evaluated previously. 8 On the other hand, some studies focused on the correlation between soft tissue structure and chondromalacia, particularly subcutaneous fat and adjacent muscles. 8,9 Radiologic findings of the knee joint differ between low-grade (grade 1, 2) and high-grade (grade 3,4) chondromalacia.…”

Section: Introductionmentioning

confidence: 99%

“…8 On the other hand, some studies focused on the correlation between soft tissue structure and chondromalacia, particularly subcutaneous fat and adjacent muscles. 8,9 Radiologic findings of the knee joint differ between low-grade (grade 1, 2) and high-grade (grade 3,4) chondromalacia. For instance, the sulcus angle and trochlear depth were shown to be significantly different between mild and severe cartilage defects.…”

Section: Introductionmentioning

confidence: 99%

Relation of the chondromalatia patellae to proximal tibial anatomical parameters, assessed with MRI

Tabary

Esfahani

Nouraie

et al. 2020

Radiology and Oncology

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BackgroundMagnetic resonance imaging (MRI) is a non-invasive highly sensitive tool for diagnosing chondromalacia patellae in the early stages. Many studies have evaluated patellar and trochlear morphology with different radiologic indices. We aimed to assess the discriminative power of tibial, patellar, and femoral indices in MRI for chondromalacia patellae.Patients and methods100 cases of chondromalacia, as well as 100 age-matched controls among the patients who underwent knee MRI between February 2017 and March 2019, were included. The standard protocol of knee MRI was applied and the diagnosis of chondromalacia was made on MRI findings. Chondromalacia subjects were also classified as grade 1 to 4 according to the Modified Outerbridge’s MRI grading system. We measured 25 MRI parameters in the knee and adjacent structures to determine the relation between chondromalacia patellae and anatomical MRI parameters.ResultsTibial slope, trochlear depth, lateral trochlear inclination, and lateral patellar tilt angle had significant correlation with chondromalacia. Any increase in lateral trochlear inclination and lateral patellar tilt angle could increase the probability of the disease (Odds ratio [OR] 1.15, 1.13; 95% CI: 1.03–1.30; 1.02–1.26, respectively), while any increase in medial tibial slope and trochlear depth could decrease the probability of chondromalacia (OR 0.85, 0.06; 95% CI: 0.73–0.98, 0.02–0.17, respectively). We also designed a model for the severity of disease by using the patellar height index (relative odds ratio: 75.9).ConclusionsThe result of this study showed the novelty role of tibial anatomy in developing chondromalacia and its mechanism. We also concluded that patellar height might be an important factor in defining disease severity.

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The influence of isolated femur and tibia rotations on patella cartilage stress: a sensitivity analysis

Cited by 29 publications

References 36 publications

Longitudinal analysis of the contribution of 3D patella and trochlear bone shape on patellofemoral joint osteoarthritic features

Longitudinal analysis of the contribution of 3D patella and trochlear bone shape on patellofemoral joint osteoarthritic features

Patellar Malalignment Is Associated With Patellofemoral Lesions and Cartilage Relaxation Times After Hamstring Autograft Anterior Cruciate Ligament Reconstruction

Relation of the chondromalatia patellae to proximal tibial anatomical parameters, assessed with MRI

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