Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Radiology, Dongguk University Ilsan Hospital, Gyeonggi-do, Republic of Korea.
Eur J Radiol. 2019 Sep;118:122-129. doi: 10.1016/j.ejrad.2019.07.012. Epub 2019 Jul 11.
To determine (1) the association between superolateral Hoffa's fat pad (SHFP) oedema and early cartilage degeneration using T2* mapping and (2) whether patellofemoral maltracking is related to cartilage T2* values or SHFP oedema.
In this retrospective study, 68 patients (71 knees) with anterior knee pain who had undergone 3-Tesla magnetic resonance imaging (MRI) were enrolled. Cartilage T2* values in medial and lateral patellofemoral compartment as well as patellofemoral maltracking parameters (trochlear angle, sulcus angle, patellar tilt angle, tibial tuberosity-to-trochlear groove [TT-TG] distance, and patellar-tendon to patellar-length [PT-PL] ratio) were compared between case group (24 knees with SHFP oedema) and control group (47 knees without the oedema). The associations between the patellofemoral maltracking and the cartilage T2* values as well as the SHFP oedema were investigated using logistic and linear regression analyses.
The case group showed significantly higher cartilage T2* value in the lateral patellar facet, wider sulcus angle, greater TT-TG distance, and higher PT-PL ratio than the control group. Both SHFP oedema and higher cartilage T2* value in the lateral patellar facet were significantly associated with wider sulcus angle, greater TT-TG distance, and higher PT-PL ratio.
SHFP oedema appears to be associated with inherent cartilage degeneration in the lateral patellar facet. Patellofemoral maltracking might be a risk factor for SHFP oedema and early cartilage damage in the lateral patellar facet.
(1)利用 T2* 映射来确定外侧髌下脂肪垫(SHFP)水肿与早期软骨退变之间的关系;(2)髌股关节对线不良与软骨 T2* 值或 SHFP 水肿之间的关系。
本回顾性研究纳入了 68 例(71 膝)前膝痛患者,这些患者均接受了 3T 磁共振成像(MRI)检查。比较病例组(24 膝有 SHFP 水肿)和对照组(47 膝无水肿)的内侧和外侧髌股关节软骨 T2* 值以及髌股关节对线不良参数(滑车角、滑车沟角、髌骨倾斜角、胫骨结节至滑车沟距离、髌腱至髌骨长度比)。使用逻辑回归和线性回归分析髌股关节对线不良与软骨 T2* 值及 SHFP 水肿之间的关系。
病例组的外侧髌骨面软骨 T2* 值明显较高,滑车沟角较宽,TT-TG 距离较大,PT-PL 比值较高。SHFP 水肿和外侧髌骨面软骨 T2* 值升高均与滑车沟角增宽、TT-TG 距离增大和 PT-PL 比值升高显著相关。
SHFP 水肿似乎与外侧髌骨面的固有软骨退变有关。髌股关节对线不良可能是 SHFP 水肿和外侧髌骨面早期软骨损伤的危险因素。