Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study

Eur Radiol. 2012 Feb;22(2):418-28. doi: 10.1007/s00330-011-2275-3. Epub 2011 Sep 29.

Abstract

Objectives: To evaluate patellofemoral congruency measurements on MRI and correlate the findings with severity of ipsilateral osteoarthritis.

Methods: We retrospectively reviewed 650 consecutive knee MRI examinations from 622 patients divided into two age groups: ≤50 and >50 year-old. The femoral sulcus angle (SA) and depth (SD), lateral patellar displacement (LPD), lateral patellofemoral angle (LPFA), tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index as well as the grade of focal cartilage defects (ranging from I to IV) in the patellofemoral region were assessed in each subject on axial and sagittal fat-saturated intermediate-w MR images.

Results: A significant difference exists between normal and knees with patellofemoral joint osteoarthritis regarding SA (p = 0.0002 and <0.0001), SD (p = 0.0004 and <0.0001), LPD (p = 0.0014 and 0.0009) and LPFA (p = 0.0002 and 0.0003) in both age groups (≤50 and >50 respectively). Significant correlation was found between grading of cartilage defects and SA (rho = 0.21, p = 0.0001 and 0.443, <0.0001), SD (rho = -0.198, p = 0.0003 and -0.418, <0.0001), LPD (rho = 0.176, p = 0.0013 and 0.251, 0.0002) and LPFA (rho = -0.204, p = 0.0002 and -0.239, 0.0005) in both age groups.

Conclusions: Knee joint anterior malalignment is multivariably associated with patellofemoral osteoarthritis.

Key points: • MRI is an excellent method to evaluate knee alignment and articular cartilage damage. • Significant associations exist between alignment parameters and osteoarthritis of the patellofemoral joint. • The "sulcus angle" and "sulcus depth" were the most valuable osteoarthritic markers.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cartilage / pathology
  • Case-Control Studies
  • Child
  • Diagnostic Imaging / methods
  • Female
  • Humans
  • Knee Joint / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Osteoarthritis / pathology*
  • Osteoarthritis / therapy
  • Osteoarthritis, Knee / pathology*
  • Patellofemoral Joint / pathology*
  • Prevalence
  • Retrospective Studies