Relationship between patellar tendon–lateral femoral condyle friction syndrome and patellofemoral instability

Rasime Pelin Kavak,Evrim Duman,Meltem Özdemi̇r

doi:10.18663/tjcl.696749

Abstract

Aim: The etiology of the patellar tendon–lateral femoral condyle friction syndrome (PTLFCFS) is not fully known and the number of studies on the diagnosis, treatment, and prognosis of PTLFCFS is limited. The aim of this study was to evaluate the relationship between PTLFCFS and patellofemoral instability in magnetic resonance imagingMaterial and Methods: Six morphological parameters were measured in magnetic resonance imaging (MRI) to evaluate patellofemoral stability in patients with PTLFCFS (study group n = 82) and patients without detection PTLFCFS (control group n = 204) in the knee MRI examination. These parameters include the Insall–Salvati ratio, ventral trochlear prominence, sulcus angle, lateral trochlear inclination angle, patellar inclination angle, and patellar lateralization measurement. In addition, the chondromalacia patella relationship was also evaluated.Results: The Insall–Salvati ratio, patellar inclination angle, patellar lateralization, sulcus angle, and ventral trochlear prominence were significantly higher and lateral trochlear inclination angle was significantly lower in the study group than in the control group. The incidence of chondromalacia patella was significantly higher in the study group. In the study group, there was a positive correlation between the chondromalacia patella and the ventral trochlear prominence. Conclusion: Among the factors causing PTLFCFS, patellofemoral instability was found to be effective. The measured parameters having high sensitivity and specificity suggest that these parameters can be used as risk factors and for the diagnosis.

Highlights

Materials and MethodsThe knee is a hinge type joint in which the patellar tendon, ligaments, and sections of fascia lata provide passive stabilization, whereas the quadriceps muscle and aponeurosis provide active stabilization [1]
There was a positive correlation between the chondromalacia patella and the ventral trochlear prominence (p < 0.05), whereas no correlation was found between the chondromalacia patella and the Insall–Salvati ratio, patellar inclination angle, patellar lateralization, sulcus angle, and lateral trochlear inclination angle (p > 0.05) (Table 2)
The incidence of chondromalacia patella was significantly higher in the study group and there was a positive correlation between the chondromalacia patella and the ventral trochlear prominence

Summary

Introduction

Materials and MethodsThe knee is a hinge type joint in which the patellar tendon, ligaments, and sections of fascia lata provide passive stabilization, whereas the quadriceps muscle and aponeurosis provide active stabilization [1]. Patellar tendon–lateral femoral condyle friction syndrome (PTLFCFS) is considered as one of the leading causes of anterior knee pain, especially seen in young people [3]. The etiology of PTLFCFS is not fully known, its pathology is considered to result from the deterioration of knee biomechanics due to previous trauma. Accepted view is that the development of inflammation in the Hoffa and the direct contact of the lateral femoral condyle and patellar tendon due to trauma lead to clinical symptoms [1,4]. With MRI, all the structures of the knee can be evaluated simultaneously, and this method allows a comprehensive understanding of the causes of anterior knee pain

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