Elsevier

Clinical Imaging

Volume 41, January–February 2017, Pages 7-10
Clinical Imaging

Original Article
Association between trochlear morphology and chondromalacia patella: an MRI study

https://doi.org/10.1016/j.clinimag.2016.09.008Get rights and content

Abstract

This study aimed to compare trochlear morphology seen in magnetic resonance imaging between patients with chondromalacia patella and age-matched control patients without cartilage lesion. Trochlear morphology was evaluated using the lateral trochlear inclination, medial trochlear inclination, sulcus angle and trochlear angle on the axial magnetic resonance images. Consequently, an association between abnormal trochlear morphology and chondromalacia patella was identified in women. In particular, women with flattened lateral trochlea are at an increased risk of patellar cartilage structural damage.

Section snippets

Introductıon

Chondromalacia patella, which is one of the major causes of chronic anterior knee pain, is characterized by the softening or breakdown of the patellar cartilage and is frequently associated with decreased quality of life. Osteoarthritis is generally associated with a progressive loss of articular cartilage [1], [2]. Osteoarthritis is a major public health concern and is expected to be the fourth leading cause of disability in the general population by 2020 because of increases in life

Patients

One hundred fifty patients who were diagnosed with Grade 3–4 patellar chondromalacia on the basis of MRI evaluation between January 2015 and October 2015 were retrospectively evaluated. The exclusion criteria were any history of knee surgery or knee trauma and an imaging finding of a patellar dislocation, inflammatory arthritis, any diagnosis of space-occupying knee lesion, and age <40 or>65 years. Thus, a total of 115 patients were included in the present study. The control group comprised an

Results

The characteristics of the study patients are presented in Table 1. The SA, LTI, MTI and TA comparisons between groups are given in Table 2. The mean LTI (P=.01) and TA (P=.001) were significantly lower in the chondromalacia patella group than those in the normal group. The mean SA was significantly higher in patients with chondromalacia patella than in control patients (P=.01). No statistically significant difference was found in MTI between the two groups (P=.55).

Discussion

The results of the present study revealed an association between patellar cartilage structural damage and trochlear morphology. Patellar cartilage defects are observed more frequently in knees with a low LTI than in those with a high LTI. This finding supports our hypothesis that knees with flattened lateral trochlea are more prone to patellar cartilage structural damage.

Osteoarthritis is a progressive degenerative disease characterized by a gradual loss of articular cartilage. The geometry of

References (18)

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    This supports the findings from Utting et al., who found a significant number of patients with PF arthritis have described preceding anterior knee pain in their adolescence and early adult years [21]. Several others have found a relationship between low lateral trochlea inclination angle or/and trochlea dysplasia and the cartilage wear/PF arthritis [22–25]. Also a reduced trochlear depth has been found to correlate with chondromalacia patella [25,26].

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