Relationship between patellofemoral joint morphology and chondromalacia patella

Acta Radiol. 2024 Jan;65(1):62-67. doi: 10.1177/02841851231169725. Epub 2023 May 1.

Abstract

Background: For the normal functioning of the patellofemoral joint (PF), the relationship between the patella and the trochlear groove must be compatible.

Purpose: To investigate the relationship between patellofemoral joint morphology (PFM) and patellar chondromalacia.

Material and methods: Overall, 136 knees of patients aged 20-55 years examined between March 2020 and March 2021 were included in this study. In all patients, trochlear sulcus angle, trochlear sulcus depth, trochlear facet asymmetry, patella alta (Insall-Salvati [IS] index), and patellar facet asymmetry were measured. Of these cases, 66 knees with an abnormality detected in any of the measurements for PFM were included in the case group. Moreover, 70 knees with demonstrating normal PFM measurements were included in the control group.

Results: The incidence and grade of chondromalacia was higher in the case group than in the control group (P < 0.001). Between the patients with and without chondromalacia trochlear sulcus angle (mean = 138.25° ± 10.02° vs. 132.58° ± 7.24°; P = 0.001), IS index (mean = 1.25 ± 0.21 vs. 1.16 ± 0.15; P = 0.014), patellar facet asymmetry (mean = 0.77 ± 0.09 vs. 0.73 ± 0.12; P = 0.039), trochlear sulcus depth (mean = 5.39 ± 1.42 mm vs. 6.27 ± 1.04 mm; P < 0.001), and trochlear facet asymmetry (mean = 0.67 ± 0.11 vs. 0.71 ± 0.09; P = 0.023) measurements, there was a significant difference.

Conclusion: The presence of at least one of the measures indicating pathology in PFM is associated with the presence and severity of chondromalacia.

Keywords: Chondromalacia; knee; patella; patella alta; patellofemoral morphology; trochlear dysplasia.

MeSH terms

  • Cartilage Diseases* / diagnostic imaging
  • Humans
  • Joint Instability*
  • Knee Joint / pathology
  • Magnetic Resonance Imaging
  • Patella / diagnostic imaging
  • Patellofemoral Joint* / anatomy & histology
  • Patellofemoral Joint* / pathology