PATELLOFEMORAL JOINT - MORPHOLOGY, DYSPLASIA AND INFLUENCE ON THE ONSET OF CHONDROMALACIA OF THE PATELLA
Abstract
The patellofemoral joint, the anterior compartment of the knee, undergoes the earliest degenerative changes throughout life and joint morphology is of great importance in the appearance of pain in the anterior knee and chondromalacia of the patella. Chondromalacia of the patella is a progressive disease with a change in normal morphology and structure, with the formation of minor or major defects in the cartilage itself and represents a significant socioeconomic problem because it occurs in young, physically active people. Quadriceps wasting, patellofemoral crepitus, and effusion are obvious clinical indications. In addition, radiological examinations are also necessary for diagnosis. Magnetic resonance imaging (MRI) is a non-invasive diagnostic method, which promises a unique ability to potentially identify cartilage lesions.
References
1. Siljander B, Tompkins M, Martinez-Cano JP. A Review of the Lateral Patellofemoral Joint: Anatomy, Biomechanics, and Surgical Procedures. J Am Acad Orthop Surg Glob Res Rev. 2022; 6(7):e21.00255.
2. Capkin S, Zeybek G, Ergur I, Kosay C, Kiray A: An anatomic study of the lateral patellofemoral ligament. Acta Orthop Traumatol Turc 2017; 51:73-6.
3. Matz J, Lanting BA, Howard JL. Understanding the patellofemoral joint in total knee arthroplasty. Can J Surg. 2019; 62(1):57-65.
4. Zheng W, Li H, Hu K, Li L, Bei M. Chondromalacia patellae: current options and emerging cell therapies. Stem Cell Res Ther. 2021; 12(1):412.
5. Zhao C, Gao X, Liu Q, Li Z, Qiu Y, Li R, Niu J, Stefanik JJ, Zhang Y, Han W, Lin J. Associations of trochlea morphology and patellofemoral alignment with prevalent radiographic patellofemoral osteoarthritis. Osteoarthritis Cartilage. 2020; 28(6):824-30.
6. Fan C, Niu Y, Wei M et al. Study on the correlation between the severity of patellofemoral arthritis and the morphology of the distal femur. BMC Musculoskelet Disord 2023; 24:90.
7. Muhsin DursunI, Murat OzsahınII, Guray AltunIII; Prevalence of chondromalacia patella according to patella type and patellofemoral geometry: a retrospective study, Sao Paulo Med J. 2022; 140(6):755-61
8. Sieroń D, Jabłońska I, Niemiec P, Lukoszek D, Szyluk K, Platzek I, Meusburger H, Delimpasis G, Christe A. Correlation of Patellofemoral Chondromalacia and Body Mass Index (BMI) in Relation to Sex and Age Analysis of 1.5T and 3.0T Magnetic Resonance (MR) Images Using the Outerbridge Scale. Med Sci Monit. 2022; 28:e937246.
9. Kamat Y, Prabhakar A, Shetty V, Naik A. Patellofemoral joint degeneration: A review of current management. J Clin Orthop Trauma. 2021; 24:101690.
10. Sebro R, Weintraub S. Knee morphometric and alignment measurements with MR imaging in young adults with central cartilage lesions of the patella and trochlea. Diagn Interv Imaging. 2017; 98(5):429-40.
11. Moyer R, Wirth W, Duryea J, Eckstein F. Anatomical alignment, but not goniometry, predicts femorotibial cartilage loss as well as mechanical alignment: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2016; 24(2):254-61.
12. Gulati A, McElrath C, Wadhwa V, Shah JP, Chhabra A. Current clinical, radiological and treatment perspectives of patellofemoral pain syndrome. Br J Radiol. 2018; 91(1086):20170456.
13. Widjajahakim R, Roux M, Jarraya M, Roemer FW, Neogi T, Lynch JA, Lewis CE, Torner JC, Felson DT, Guermazi A, Stefanik JJ. Relationship of Trochlear Morphology and Patellofemoral Joint Alignment to Superolateral Hoffa Fat Pad Edema on MR Images in Individuals with or at Risk for Osteoarthritis of the Knee: The MOST Study. Radiology. 2017; 284(3):806-14.
14. Macri EM, Felson DT, Zhang Y, Guermazi A, Roemer FW, Crossley KM, Khan KM, Stefanik JJ. Patellofemoral morphology and alignment: reference values and dose-response patterns for the relation to MRI features of patellofemoral osteoarthritis. Osteoarthritis Cartilage. 2017; 25(10):1690-7.
15. Yang G, Dai Y, Dong C, Niu Y, Kang H, Wang F. Two-type classification system for femoral trochlear dysplasia in recurrent patellar instability based on three-dimensional morphology. Knee Surg Sports Traumatol Arthrosc. 2022.
16. Aglietti P, Insall JN, Cerulli G. Patellar pain and incongruence. I: Measurements of incongruence. Clin Orthop Relat Res. 1983(176): 217-24.
17. Tomczyk J, Rachalewski M, Bianek-Bodzak A, Domżalski M. Anatomical variations of knee ligaments in magnetic resonance imaging: a pictorial essay. Folia Morphol (Warsz). 2019; 78(3):467-75.
18. Christoforakis JJ, Strachan RK. Internal derangements of the knee associated with patellofemoral joint degeneration. Knee Surg Sports Traumatol Arthrosc. 2005; 13(7):581-4.
19. Fick CN, Grant C, Sheehan FT. Patellofemoral Pain in Adolescents: Understanding Patellofemoral Morphology and Its Relationship to Maltracking. Am J Sports Med. 2020; 48(2):341-50.
20. Buckwalter JA, Simon SR. Orthopaedic Basic Science: Biology and Biomechanics of the Musculoskeletal System 2ed: American Academy of Orthopaedic Surgeons; 2000.
21. Glaser C. New techniques for cartilage imaging: T2 relaxation time and diffusion-weighted MR imaging. Radiol Clin North Am. 2005; 43(4):641-53.
22. van Eck CF, Kingston RS, Crues JV, Kharrazi FD. Magnetic Resonance Imaging for Patellofemoral Chondromalacia: Is There a Role for T2 Mapping? Orthop J Sports Med. 2017; 5(11):2325967117740554.
23. Crema MD, Roemer FW, Marra MD, Burstein D, Gold GE, Eckstein F, Baum T, Mosher TJ, Carrino JA, Guermazi A. Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics. 2011; 31(1):37-61.
24. Dai Y, Yin H, Xu C, Zhang H, Guo A, Diao N. Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis. J Orthop Surg Res. 2021; 16(1):548.