CLINICO-RADIOLOGICAL PARAMETERS OF THE PATELLOFEMORAL JOINT IN MALES AND FEMALES WITH NON-PATELLOFEMORAL KNEE PROBLEMS: A COMPARATIVE ANALYSIS

SHASHANK CHANDRA; REHAN-UL-HAQ; MALAY CHAUDHARY; ADITYA NATH AGGARWAL

doi:10.22159/ijcpr.2023v15i5.3050

Authors

SHASHANK CHANDRA Safdarjung Hospital, New Delhi, India
REHAN-UL-HAQ AIIMS Bhopal, Madhya Pradesh, India
MALAY CHAUDHARY Safdarjung Hospital, New Delhi, India
ADITYA NATH AGGARWAL UCMS, New Delhi, India

DOI:

https://doi.org/10.22159/ijcpr.2023v15i5.3050

Keywords:

Patellofemoral joint, Patellar instability, Q angle, Imaging techniques

Abstract

Objective: Osteoarthritis of the knee joint is a common condition that primarily affects the elderly. While previous studies have focused on the tibiofemoral compartment, the significance of the patellofemoral compartment needs to be considered. Patellofemoral joint problems frequently occur in orthopedics and sports medicine and can be challenging to diagnose. Various classification systems have been developed to categorize patellofemoral pathology. Clinical evaluation, as well as imaging techniques such as X-rays and computed tomography (CT), are commonly used for assessment. However, there is a lack of published studies defining and validating MRI parameters for routine clinical assessment of patellofemoral joint abnormalities.

Methods: This comparative analytical study was conducted at the Department of Orthopedics, UCMS and GTB Hospital, Delhi, from November 2017 to April 2019. The sample size included 30 male and 30 female participants between the ages of 18 and 45 y. The study evaluated various clinical, radiographic, and MRI parameters of the patellofemoral joint in both males and females. Statistical analysis was performed to determine any significant differences between the genders.

Results: The clinical evaluation revealed a slightly higher mean Q angle in females compared to males, although this difference was not statistically significant. Lateral radiographs showed a significant difference in the Insall-Salvati ratio between genders, while the modified Insall-Salvati ratio and Caton-Deschamps index did not show significant differences. MRI measurements demonstrated a significant difference in the I/S ratio between males and females, while other parameters did not exhibit significant gender differences.

Conclusion: This study provides valuable insights into the differences in clinical, radiographic, and MRI parameters of the patellofemoral joint between adult males and females. The findings suggest that gender differences exist in certain measurements, emphasizing the need for gender-specific evaluation. Further research is required to explore the clinical implications of these differences and to establish normative values for MRI parameters in routine clinical practice.

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References

Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM. Osteoarthritis: new insights. Part 1: The disease and its risk factors. Ann Intern Med. 2000;133(8):635-46. doi: 10.7326/0003-4819-133-8-200010170-00016, PMID 11033593.

Crossley KM, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM. Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016;50(14):839-43. doi: 10.1136/bjsports-2016-096384, PMID 27343241.

Sextro GS, Berry DJ, Rand JA. Total knee arthroplasty using cruciate-retaining kinematic condylar prosthesis. Clin Orthop Relat Res. 2001;(388):33-40. doi: 10.1097/00003086-200107000-00007. PMID 11451130.

Lin F, Wang J, Tang G, Zhao J, Li X, Pei F. Reliability and accuracy of the measurement of patellar height ratio on axial views of computer tomography. Knee Surg Sports Traumatol Arthrosc. 2011;19(10):1656-61. doi: 10.1007/s00167-011-1453-5.

Weiss MD, Wasdell MB, Bomben MM, Rea KJ, Freeman RD. Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia. Journal of the American Academy of Child & Adolescent Psychiatry. 2006;45(5):512-9. doi: 10.1097/01.

Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40(2):42-51. doi: 10.2519/jospt.2010.3337, PMID 20118526.

Van Haver A, De Roo K, De Beule M, Labey L, De Baets P, Dejour D. Reliability of CT scan for trochlear dysplasia classification. Skelet Radiol. 2011;40(12):1533-8. doi: 10.1007/s00256-011-1194-4.

Van Haver A, De Roo K, De Beule M, Labey L, De Baets P, Dejour D. Morphological study of the sulcus of the human femoral trochlea. Surg Radiol Anat. 2012;34(7):585-95. doi: 10.1007/s00276-012-0949-5.

Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA. Epidemiology and natural history of acute patellar dislocation. Am J Sports Med. 2004;32(5):1114-21. doi: 10.1177/0363546503260788, PMID 15262631.

Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG. Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther. 2003;33(11):677-85. doi: 10.2519/jospt.2003.33.11.677, PMID 14669963.

Elias JJ, Cosgarea AJ. Technical errors during medial patellofemoral ligament reconstruction could overload medial patellofemoral cartilage: a computational analysis. Am J Sports Med. 2006;34(9):1478-85. doi: 10.1177/0363546506287486, PMID 16685097.

McNulty AL, Rothfusz NE, Leddy HA, Guilak F. Synovial fluid concentrations and relative potency of interleukin-1 alpha and beta in cartilage and meniscus degradation. J Orthop Res. 2013;31(7):1039-45. doi: 10.1002/jor.22334. PMID 23483596.