The relation between chondromalacia patella and meniscal tear and the sulcus angle/ trochlear depth ratio as a powerful predictor

Reşorlu, Hatice; Zateri, Çoşkun; Nusran, Gürdal; Göksel, Ferdi; Aylanç, Nilüfer

doi:10.3233/bmr-160536

Cited by 17 publications

(28 citation statements)

References 21 publications

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“…Although it has been suggested that a wide variety of factors including trauma, anatomical predisposition, patellofemoral malalignment, and overuse contributes to the formation of CMP, the actual cause of CMP has not been clarified 6. In several recent studies, the relation between CMP and knee morphometric and alignment measurements in young adults has been evaluated 5,7891011. CMP has also been associated with the formation of edema in the superolateral region of the Hoffa's fat pad (SHFP) 8.…”

Section: Introductionmentioning

confidence: 99%

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

Özdemir

Kavak

2019

IJOO

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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.

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Section: Introductionmentioning

confidence: 99%

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

Özdemir

Kavak

2019

IJOO

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“… 5 , 18 One recent study proposed the sulcus angle/trochlear depth ratio as a powerful predictor. 11 One limitation of our study is that patellar and trochlear morphology were not evaluated. Another limitation is that due to its retrospective nature patients were not assessed in terms of diabetes during the study.…”

Section: Discussionmentioning

confidence: 97%

“…Trauma, degenerative changes, morphological variations, mechanical stress impairments and aging are factors involved in the etiology of OA, CP, bursitis and medial meniscal tear. 3 , 11 Common risk factors are one of the reasons why pathologies in the knee joint affect more than one anatomical structure, rather than remaining local. Moreover, pathologies that begin locally induce morphological and functional changes in other anatomical structures by compromising biomechanics.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between chondromalacia patella, medial meniscal tear and medial periarticular bursitis in patients with osteoarthritis

Reşorlu

Döner

Karatağ

et al. 2017

Radiology and Oncology

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BackgroundThis study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears.Patients and methodsRadiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients.ResultsMild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p < 0.001 and p = 0.018, respectively). Significant correlation was observed between medial meniscal tear and bursitis in the medial compartment (p = 0.038). Presence of medial periarticular bursitis was positively correlated with severity of osteoarthritis but exhibited no correlation with chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients.ConclusionsWe observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear.

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“…Patellofemoral eklem problemlerin tanısında hâlâ bilinmeyen birçok nokta mevcuttur. Tanıda kullanılan metotların güvenilirliği literatürde tartışılmıştır (27,28). Günümüzde hâlen dinamik Bilgisayarlı Tomografi (BT) ve MRG patellofemoral eklemin dizilim bozukluğunun analizinde geniş kullanım alanı bulmuştur (29).…”

Section: P-pt (°)unclassified

Evaluation of the Relationship between Sagittal Plan Changes of the Patellofemoral Joint with Quadriceps Muscle Atrophy in Patients Undergoing Antegrade Locked Intramedullary Femoral Nailing

Calisal¹,

Pepe²,

Karasoy³

et al. 2019

Akd Med J

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ÖZAmaç: Antegrad femoral intramedüller çivileme sonrası patellofemoral eklemde gelişen sagital dizilim bozukluklarının kuadriseps kas atrofisi ile ilişkisini araştırmak.Gereç ve Yöntemler: Çalışmada ameliyat sonrası opere ekstremitede diz önü ağrısı olan 24 hastanın (9 erkek ve 15 kadın) dinamik patellofemoral manyetik rezonans görüntüleme (MRG) sonuçları incelendi. Rotasyonel deformitesi ve horizontal planda patellofemoral dizilim bozukluğu olan hastalar çalışma dışı bırakıldı. Klinik değerlendirme, hastaların son takiplerinde Kujala patellofemoral skorlama sistemi ile yapıldı. Diz dinamik MRG çekimleri supin pozisyonda ve bilateral yapıldı. Sağlam ve opere ekstremitede patellofemoral eklem; istirahat ve belirlenen fleksiyon açılarında, P-PT (patella-patellar tendon) açı ölçümleri ve DP-TT (distal patella-tüberositaz tibia) mesafe ölçümleri ile değerlendirildi. Aynı zamanda kuadrisepsin kontraksiyonlu ve kontraksiyonsuz iken enine kesit alan ölçümleri yapıldı. Hastaların opere ve sağlam ekstremitelerindeki kuadriseps enine kesit alanı, P-PT açı ve DP-TT mesafe ölçümleri arasındaki ilişkiye bakıldı.Bulgular: Hastaların ortalama yaşı 39,7±13,9 yıl idi. Ortalama takip süreleri 40 (16-64) ay idi. Hastaların kujala patellofemoral skorları ortalama 73,3±11,8 idi. Opere taraf P-PT açı değişimleri sağlam tarafa göre anlamlı olarak yüksek bulunurken, DP-TT mesafe değişimleri sağlam tarafa göre anlamlı olarak düşük bulundu. Aynı zamanda P-PT açısındaki artış ile DP-TT mesafesindeki azalmanın birbirleriyle anlamlı olduğu tespit edildi. Opere taraf kuadriseps kasının enine kesit alanının kontraksiyonlu ve kontraksiyonsuz değerleri, sağlam tarafa göre anlamlı olarak düşük bulundu.Sonuç: Antegrad femoral kilitli intramedüller çivileme sonrası diz önü ağrısı olan hastalarda, patellada gelişen sagital plan değişimleri ve kuadriseps atrofisi diğer nedenlerle beraber patellofemoral eklemin biyomekaniğini etkiler. ABSTRACTObjective: The aim of the study was to analyse the relationship between sagittal plane alignment of patellofemoral joint and quadriceps muscle mass chance after antegrade femoral intramedullary nailing. Material and Methods:The dynamic patellofemoral magnetic resonance imaging results of 24 patients (9 males and 15 females) who had anterior knee pain in the operated extremity after surgery were reviewed in the study. Patients with rotational deformities and horizontal plane patellofemoral Yazışma Adresi Correspondence AddressEmre CALIŞAL

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The relation between chondromalacia patella and meniscal tear and the sulcus angle/ trochlear depth ratio as a powerful predictor

Abstract: An increased trochlear sulcus angle/trochlear depth ratio is a significant predictor of chondromalacia patella. Medial meniscus injury is more prevalent in patients with chondromalacia patella in association with impairment in knee biomechanics and the degenerative process.

Cited by 17 publications

References 21 publications

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

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

The relationship between chondromalacia patella, medial meniscal tear and medial periarticular bursitis in patients with osteoarthritis

Evaluation of the Relationship between Sagittal Plan Changes of the Patellofemoral Joint with Quadriceps Muscle Atrophy in Patients Undergoing Antegrade Locked Intramedullary Femoral Nailing

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