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. 2024 Feb 1;6(2):100855.
doi: 10.1016/j.asmr.2023.100855. eCollection 2024 Apr.

Supratrochlear Rim is Correlated with Isolated Patellar Chondromalacia on Magnetic Resonance Imaging of the Knee

Artur Banach  1 , Nobuhiko Hata  1 , Ross Crawford  2 , Tomasz Piontek  3   4
Affiliations

Supratrochlear Rim is Correlated with Isolated Patellar Chondromalacia on Magnetic Resonance Imaging of the Knee

Artur Banach et al. Arthrosc Sports Med Rehabil. .

Abstract

Purpose: To investigate the relationship between the supratrochlear rim and isolated patellar chondromalacia (PC) using magnetic resonance imaging (MRI) scans of the knee.

Methods: Patients without patellofemoral pain (control group) and patients with patellofemoral pain and diagnosed with stage III or IV PC based on MRI (defect group) were retrospectively identified. Patients with a history of patellar subluxation were excluded. We used patient MRI scans to perform 20 anatomical measurements of the patellofemoral joint. We also performed 2 measurements of the anterior femoral curvature. A total of 30 patients (29 ± 8.7 years) were in the control group, and 20 patients were in the defect group (29.4 ± 9.7 years).

Results: The maximum curvature (P < .001) and mean curvature (P < .001) of the anterior femoral condyle were found statistically significantly different between the groups. Patellotrochlear index (P = .03) and Insall-Salvati index (P < .001) were also found statistically significantly different between the 2 groups. Patella type III and trochlear dysplasia grade B were found more common in the defect group.

Conclusions: In this Level III prognostic, case-control study, we have shown through MRI knee measurements that the isolated patellar chondromalacia in patients without a history of patellar subluxation and dislocation is correlated with the increased anterior femoral curvature in combination with patella alta.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships, which may be considered as potential competing interests: T.P. reports personal fees from Rehasport Clinic outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

Figures

Fig 1
Fig 1
MRI comparison of healthy patellar cartilage of right knee (a), and patellar chondromalacia of right knee (b) in the axial plane.
Fig 2
Fig 2
Measurements of the curvature and PTI in a control left knee (a) and left knee with PC (b). PH indicates patellar height; PAO, patellar articular overlap. PTI = PAO/PH.
Fig 3
Fig 3
Measurements illustrated on right knees. PDL indicates patellar diagonal length; PTL, patellar tendon length; SGL, sulcus groove length; PH, patellar height; TA, trochlear angle; MTI, medial trochlea inclination; LTI, lateral trochlea inclination. Trochlear depth =e+g2−f.
Fig 4
Fig 4
Patient inclusion process.
Fig 5
Fig 5
Boxplots of statistically significant results: Maximum Curvature, Mean Curvature, PTI at 0° flexion, Insall-Salvati Index.
Fig 6
Fig 6
Examples of two knees with PC and femoral condylar rim. (A) Left illustrates a 3-dimensional (3D) reconstruction of a right femur with an indicated rim, and (a) Right is the same femur with articular cartilage displayed in green and damaged patellar cartilage in yellow. (B) Left illustrates a 3D reconstruction of a left femur with an indicated rim, and (b) right is the same left femur with articular cartilage displayed in green and damaged patellar cartilage in yellow.
Fig 7
Fig 7
Supratrochlear rim in arthroscopic view of left knee (left) and in open surgery of right knee (right). Both images were taken in patients with PC without a history of patellar subluxation.
See this image and copyright information in PMC

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