Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People's Republic of China.
Eur Radiol. 2020 Apr;30(4):2261-2269. doi: 10.1007/s00330-019-06592-z. Epub 2020 Jan 3.
To determine the correlation between patellar tendon-lateral femoral condyle friction syndrome (PLFFS) and the morphological characteristics of the antero-inferior part of the lateral femoral condyle (ALFC) to explore the potential pathogenesis.
A total of 170 knees of 140 patients with PLFFS (PLFFS group) were retrospectively analyzed using magnetic resonance imaging (MRI) data for a 4-year period from our database. The Insall-Salvati ratio, shape of the ALFC (SALFC, defined as two subtypes: sharp versus blunt), lateral femoral condyle angle (LFCA), lateral trochlear length (LTL), and lateral trochlear height (LTH) were measured on MRI. Two groups were enrolled as controls: pure patella alta group (n = 192) and normal group (n = 172). All the parameters of the PLFFS group were compared with those of the two control groups.
The LFCA was significantly lower (p < 0.001) in the PLFFS group than in the pure patella alta group. The SALFC was significantly different (p < 0.001) in these two groups, whereas the Insall-Salvati ratio, LTH, and LTL showed no significant difference. The LFCA, LTH, SALFC, and the Insall-Salvati ratio in the PLFFS group were also significantly different (p < 0.001) with the normal group. Receiver operating characteristic (ROC) analysis showed the efficacy of the Insall-Salvati ratio and SALFC was better than that of the other parameters.
The morphological characteristics of ALFC are correlated with PLFFS. The sharp shape of ALFC may be an important causative co-factor along with patella alta in the pathogenesis of PLFFS.
• A sharp margin of the antero-inferior lateral femoral condyle is an important risk factor for the development of PLFFS in patients with patella alta. • Antero-inferior femoral condyle shape can easily be assessed with high intra- and inter-reader reliability PLFFS. • PLFFS is more common in young adults.
确定髌腱-外侧股骨髁摩擦综合征（PLFFS）与外侧股骨髁前下部分（ALFC）形态特征之间的相关性，以探讨潜在的发病机制。
回顾性分析了我院数据库中 4 年内的 140 例 170 膝 PLFFS 患者的磁共振成像（MRI）资料。测量 MRI 上的 Insall-Salvati 比值、ALFC 形状（SALFC，定义为两种亚型：锐 vs 钝）、外侧股骨髁角（LFCA）、外侧滑车长度（LTL）和外侧滑车高度（LTH）。纳入两组对照组：单纯髌骨高位组（n=192）和正常组（n=172）。将 PLFFS 组的所有参数与两组对照组进行比较。
PLFFS 组 LFCA 明显低于单纯髌骨高位组（p<0.001）。这两组的 SALFC 明显不同（p<0.001），而 Insall-Salvati 比值、LTH 和 LTL 无明显差异。PLFFS 组的 LFCA、LTH、SALFC 和 Insall-Salvati 比值与正常组也有显著差异（p<0.001）。受试者工作特征（ROC）分析显示 Insall-Salvati 比值和 SALFC 的疗效优于其他参数。
ALFC 的形态特征与 PLFFS 相关。ALFC 的锐缘可能是髌骨高位患者 PLFFS 发病机制中的一个重要致病协同因素。
外侧股骨髁前下部分的尖锐边缘是髌骨高位患者发生 PLFFS 的重要危险因素。
前下外侧股骨髁形状可以很容易地通过高的内部和内部读者可靠性 PLFFS 进行评估。
PLFFS 在年轻成人中更为常见。
