Abstract
Purpose
Localized articular cartilage degeneration in the patellofemoral joint is a common but yet understudied condition in younger patients. The purpose of this paper was to determine whether there are significant differences in radiographic alignment between those with and without isolated lateral patellofemoral degeneration.
Methods
Subjects with isolated symptomatic lateral patellofemoral degeneration and control subjects with no radiographic degeneration participated in the study. Variables of interest included the Caton-Deschamps index, sulcus angle, lateral patellofemoral angle, Dejour classification of trochlear dysplasia, patella linear displacement and the tibial tubercle-trochlear groove distance.
Results
We found significant differences between the patellofemoral degeneration group versus control group, respectively, for the Caton-Deschamps index (1.12 ± 0.1 vs. 1.00 ± 0.1), lateral patellofemoral angle (10.6 ± 4.3 vs. 16.6 ± 5.5) and tibial tubercle-trochlear groove distance (16.6 ± 4.0 vs. 9.0 ± 4.3). However, we found no difference in the sulcus angle (141.2 ± 8.2 vs. 137.0 ± 6.0), patella linear displacement (3.7 ± 1.9 vs. 4.0 ± 1.7) or in the Dejour Classification.
Conclusion
It appears that isolated lateral patellofemoral degeneration is associated with specific radiographic indices. Even though the radiographic measures in patients with degeneration may not be considered pathologic, they are “high normal” and may represent a risk factor for the development of focal chondral degeneration in the lateral trochlea and patella.
Level of evidence
III.
Similar content being viewed by others
References
Ali SA, Helmer R, Terk MR (2010) Analysis of the patellofemoral region on MRI: association of abnormal trochlear morphology with severe cartilage defects. AJR Am J Roentgenol 194(3):721–727
Beaconsfield T, Pintore E, Maffulli N, Petri GJ (1994) Radiological measurements in patellofemoral disorders. A review. Clin Orthop Relat Res 308:18–28
Bereiter HGE (1994) Die trochleaplastik als chirurgische Therapie der rezidivierenden Patellaluxation bei Trochleadysplasie des Femurs. Arthroskopie 7:281–286
Cahue S, Dunlop D, Hayes K, Song J, Torres L, Sharma L (2004) Varus-valgus alignment in the progression of patellofemoral osteoarthritis. Arthritis Rheum 50(7):2184–2190
Chia SL, Merican AM, Devadasan B, Strachan RK, Amis AA (2009) Radiographic features predictive of patellar maltracking during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17(10):1217–1224
Crossley KM, Marino GP, Macilquham MD, Schache AG, Hinman RS (2009) Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoarthritis? Arthritis Care Res 61(12):1719–1725
Dejour D, Le Coultre B (2007) Osteotomies in patello-femoral instabilities. Sports Med Arthrosc 15(1):39–46
Dejour H, Walch G, Nove-Josserand L, Guier C (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 2(1):19–26
Duncan RC, Hay EM, Saklatvala J, Croft PR (2006) Prevalence of radiographic osteoarthritis—it all depends on your point of view. Rheumatology 45(6):757–760
Gomoll AH, Minas T, Farr J, Cole BJ (2006) Treatment of chondral defects in the patellofemoral joint. J Knee Surg 19(4):285–295
Grelsamer RP, Dejour D, Gould J (2008) The pathophysiology of patellofemoral arthritis. Orthop Clin North Am 39(3):269–274
Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Hayes M, Wolf PA, Kreger BE, Kannel WB (1994) The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 84(3):351–358
Guney A, Bilal O, Oner M, Halici M, Turk Y, Tuncel M (2010) Short- and mid-term results of plica excision in patients with mediopatellar plica and associated cartilage degeneration. Knee Surg Sports Traumatol Arthrosc 18(11):1526–1531
Harilainen A, Lindroos M, Sandelin J, Tallroth K, Kujala UM (2005) Patellofemoral relationships and cartilage breakdown. Knee Surg Sports Traumatol Arthrosc 13(2):142–144
Henderson IJ, Lavigne P (2006) Periosteal autologous chondrocyte implantation for patellar chondral defect in patients with normal and abnormal patellar tracking. Knee 13(4):274–279
Kalichman L, Zhang Y, Niu J, Goggins J, Gale D, Felson DT, Hunter D (2007) The association between patellar alignment and patellofemoral joint osteoarthritis features—an MRI study. Rheumatology (Oxford) 46(8):1303–1308
Kalichman L, Zhang Y, Niu J, Goggins J, Gale D, Zhu Y, Felson D, Hunter D (2007) The association between patellar alignment on magnetic resonance imaging and radiographic manifestations of knee osteoarthritis. Arthritis Res Ther 9(2):R26
Panni AS, Cerciello S, Maffulli N, Di Cesare M, Servien E, Neyret P (2011) Patellar shape can be a predisposing factor in patellar instability. Knee Surg Sports Traumatol Arthrosc 19(4):663–670
Pascual-Garrido C, Slabaugh MA, L’Heureux DR, Friel NA, Cole BJ (2009) Recommendations and treatment outcomes for patellofemoral articular cartilage defects with autologous chondrocyte implantation: prospective evaluation at average 4-year follow-up. Am J Sports Med 37(Suppl 1):33S–41S
Paulos LE, O’Connor DL, Karistinos A (2008) Partial lateral patellar facetectomy for treatment of arthritis due to lateral patellar compression syndrome. Arthroscopy 24(5):547–553
Rue JP, Colton A, Zare SM, Shewman E, Farr J, Bach BR Jr, Cole BJ (2008) Trochlear contact pressures after straight anteriorization of the tibial tuberosity. Am J Sports Med 36(10):1953–1959
Schoettle PB, Zanetti M, Seifert B, Pfirrmann CW, Fucentese SF, Romero J (2006) The tibial tuberosity-trochlear groove distance; a comparative study between CT and MRI scanning. Knee 13(1):26–31
Schottle PB, Fucentese SF, Pfirrmann C, Bereiter H, Romero J (2005) Trochleaplasty for patellar instability due to trochlear dysplasia: a minimum 2-year clinical and radiological follow-up of 19 knees. Acta Orthop 76(5):693–698
Tavernier T, Dejour D (2001) Knee imaging: what is the best modality. J Radiol 82(3 Pt 2):387–405 407–488
Tecklenburg K, Dejour D, Hoser C, Fink C (2006) Bony and cartilaginous anatomy of the patellofemoral joint. Knee Surg Sports Traumatol Arthrosc 14(3):235–240
Urch SE, Tritle BA, Shelbourne KD, Gray T (2009) Axial linear patellar displacement: a new measurement of patellofemoral congruence. Am J Sports Med 37(5):970–973
Wilson T (2007) The measurement of patellar alignment in patellofemoral pain syndrome: are we confusing assumptions with evidence? J Orthop Sports Phys Ther 37(6):330–341
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Noehren, B., Duncan, S. & Lattermann, C. Radiographic parameters associated with lateral patella degeneration in young patients. Knee Surg Sports Traumatol Arthrosc 20, 2385–2390 (2012). https://doi.org/10.1007/s00167-012-1884-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-012-1884-y