Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Munhwa-dong, Jung-gu, Daejeon, 301-721, South Korea.
Knee Surg Sports Traumatol Arthrosc. 2020 Aug;28(8):2609-2618. doi: 10.1007/s00167-020-05892-y. Epub 2020 Mar 3.
Infrapatellar fat pad (IPFP) syndrome and medial patellar plica (MPP) syndrome are two recognized causes of anterior knee pain. However, diagnosing these syndromes is challenging without arthroscopic examination. The aim of this study was to evaluate sagittal patellar tilt in patients with IPFP syndrome or MPP syndrome by measuring the patella-patellar tendon angle (PPTA) in affected patients.
Eighty-three patients with anterior knee pain who underwent diagnostic arthroscopy that confirmed isolated IPFP or MPP syndrome from 2011 to 2016 were included in this retrospective study. Patients were divided into Group A (IPFP syndrome, n = 44) and Group B (MPP syndrome, n = 39). The control group included 78 patients without knee pathology who underwent magnetic resonance imaging (MRI) of the knee during the study period. Radiographic measurements, including PPTA, IPFP area, patellar height, axial patellar alignment, patellar tilt, sulcus angle, and lateral trochlear inclination, were made on MRI images by two experienced sports medicine orthopedists.
The mean PPTA in each knee-pathology group was significantly smaller than that in the control group (Group A: 137.3° ± 4.9°; Group B: 138.1° ± 3.2°; control group, 141.4° ± 2.9°). There was no significant difference between groups for any other radiographic parameter evaluated.
The PPTA was significantly smaller in patients with IPFP syndrome or MPP syndrome than in healthy controls. Therefore, sagittal patellar tilt should be included in the routine evaluation of patients with anterior knee pain. Evaluation of PPTA may help to diagnose IPFP syndrome or MPP syndrome.
Level IV.
髌下脂肪垫（IPFP）综合征和内侧髌股滑膜皱襞（MPP）综合征是两种公认的引起膝关节前侧疼痛的原因。然而，如果没有关节镜检查，这些综合征的诊断具有挑战性。本研究的目的是通过测量髌腱-髌骨角（PPTA）来评估 IPFP 综合征或 MPP 综合征患者的髌股倾斜程度。
本回顾性研究纳入了 2011 年至 2016 年间因膝关节前侧疼痛接受关节镜诊断且确诊为孤立性 IPFP 或 MPP 综合征的 83 例患者。患者分为 A 组（IPFP 综合征，n=44）和 B 组（MPP 综合征，n=39）。对照组包括 78 例在研究期间接受膝关节 MRI 的无膝关节病变患者。由两位经验丰富的运动医学骨科医生在 MRI 图像上进行放射学测量，包括 PPTA、IPFP 面积、髌骨高度、轴向髌骨对线、髌骨倾斜度、滑车沟角和外侧滑车倾斜度。
每个膝关节病变组的平均 PPTA 均显著小于对照组（A 组：137.3°±4.9°；B 组：138.1°±3.2°；对照组：141.4°±2.9°）。评估的其他任何放射学参数在两组之间均无显著差异。
与健康对照组相比，IPFP 综合征或 MPP 综合征患者的 PPTA 显著较小。因此，髌股倾斜应纳入膝关节前侧疼痛患者的常规评估中。PPTA 的评估可能有助于诊断 IPFP 综合征或 MPP 综合征。
IV 级。
