Michel D Crema1,2,3, Larissa G Cortinas4, Giovanni B P Lima4, Rene Jorge Abdalla5,6, Sheila Jean McNeill Ingham5,6, Abdalla Y Skaf4. 1. Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil. michelcrema@gmail.com. 2. Department of Radiology, Hôpital Saint-Antoine, University Paris VI, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France. michelcrema@gmail.com. 3. Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA. michelcrema@gmail.com. 4. Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil. 5. Department of Orthopaedic Surgery, School of Medicine, Federal University of São Paulo, São Paulo, Brazil. 6. Knee Institute, Hospital do Coração (HCor), São Paulo, SP, Brazil.
Abstract
OBJECTIVE: To assess the differences in morphology and alignment of the knee between patients with proximal patellar tendinopathy (PPT) and a control group, using MRI and focusing on the patellofemoral joint. METHODS: We retrospectively included 35 patients with clinically diagnosed and unequivocal findings of PPT on knee MRI, the case group. For the control group, we included 70 patients who underwent knee MRI for other reasons, with no clinical or MRI evidence of PPT. Patients and controls were matched for age and gender, with all subjects reporting frequent physical activity. MRIs were evaluated by two musculoskeletal radiologists, who assessed parameters of patellar morphology, trochlear morphology, patellofemoral alignment, and tibiofemoral alignment. The differences in parameters between cases and controls were assessed using Student's t test. Logistic regression was applied to assess the associations between the MRI parameters and the presence of PPT. RESULTS: The patellar height Insall-Salvati ratio was different between cases and controls (1.37 ± 0.21 vs. 1.24 ± 0.19; p = 0.003). The subchondral Wiberg angle was higher in cases than controls (136.8 ± 7.4 vs. 131.7 ± 8.8; p = 0.004). After applying logistic regression, significant associations with PPT were found [odds ratios (95% CI)] for patellar morphology [1.1 (1.0, 1.2)] and patellar height [1.3 (1.0, 1.7)]. CONCLUSIONS: Patellar height and the subchondral patellar Wiberg angle were greater in patients with PPT and significantly associated with PPT.
OBJECTIVE: To assess the differences in morphology and alignment of the knee between patients with proximal patellar tendinopathy (PPT) and a control group, using MRI and focusing on the patellofemoral joint. METHODS: We retrospectively included 35 patients with clinically diagnosed and unequivocal findings of PPT on knee MRI, the case group. For the control group, we included 70 patients who underwent knee MRI for other reasons, with no clinical or MRI evidence of PPT. Patients and controls were matched for age and gender, with all subjects reporting frequent physical activity. MRIs were evaluated by two musculoskeletal radiologists, who assessed parameters of patellar morphology, trochlear morphology, patellofemoral alignment, and tibiofemoral alignment. The differences in parameters between cases and controls were assessed using Student's t test. Logistic regression was applied to assess the associations between the MRI parameters and the presence of PPT. RESULTS: The patellar height Insall-Salvati ratio was different between cases and controls (1.37 ± 0.21 vs. 1.24 ± 0.19; p = 0.003). The subchondral Wiberg angle was higher in cases than controls (136.8 ± 7.4 vs. 131.7 ± 8.8; p = 0.004). After applying logistic regression, significant associations with PPT were found [odds ratios (95% CI)] for patellar morphology [1.1 (1.0, 1.2)] and patellar height [1.3 (1.0, 1.7)]. CONCLUSIONS: Patellar height and the subchondral patellar Wiberg angle were greater in patients with PPT and significantly associated with PPT.
Authors: Karen J Mohr; Ronald S Kvitne; Marilyn M Pink; Bradley Fideler; Jacquelin Perry Journal: Clin Orthop Relat Res Date: 2003-10 Impact factor: 4.176
Authors: Tomas Fernandez-Jaén; Fernando Sanz-Zapata; Jesus Manuel Cortés; Ramon Balius-Mata; Guillermo Alvarez-Rey; Jose Ignacio Garrido-Gonzalez; Carlos Colmenero-Rolon; Isabel Recio-Alvarez; Pedro Guillen-Garcia Journal: Orthop J Sports Med Date: 2020-08-31