Cilengir Atilla Hikmet, Cetinoglu Yusuf Kenan, Kazimoglu Cemal, Gelal Mustafa Fazil, Mete Berna Dirim, Elmali Ferhan, Tosun Ozgur
Basaksehir Cam and Sakura City Hospital, Department of Radiology, 34480, Istanbul, Turkey.
Batman Training and Research Hospital, Department of Radiology, 72070, Batman, Turkey.
Eur J Radiol. 2021 Jun;139:109719. doi: 10.1016/j.ejrad.2021.109719. Epub 2021 Apr 14.
To investigate the association between the knee joint anatomical variations and pathologies, and to describe the quadriceps patellar tendon angle (QPA).
MRIs of 406 cases with a lateral patellar tilt angle (LPT)>5° and a control group of 40 cases with an LPT<5° were retrospectively evaluated. QPA, LPT, trochlear sulcus angle (TSA), tibial tubercle-trochlear groove distance (TT-TG), Insall-Salvati index (ISI), patellar tendon length (PTL), patellar height (PH), lateral trochlear inclination (LTI), trochlear facet asymmetry ratio (TFA) and trochlear depth (TD) were measured. Presence of fat-pad oedema, patellar and trochlear chondromalacia, patellar and quadriceps tendinosis and effusion were evaluated.
The medians of TSA, PTL, ISI and TT-TG were significantly higher; LTI, TFA and TD were significantly lower in the patient group. The prevalence of SL-Hoffa, non-SL-Hoffa, suprapatellar and prefemoral fat-pad oedema, effusion and chondromalacia were significantly higher in the patient group. LPT was found to be positively correlated with TSA and TT-TG, and negatively correlated with LTI and TD. Cases with trochlear dysplasia, patellar chondromalacia and quadriceps tendinosis had significantly higher LPT. There was a positive correlation between QPA and TSA and a negative correlation between QPA and LTI. Cases with trochlear dysplasia, non-SL-Hoffa oedema, prefemoral fat-pad oedema and quadriceps tendinosis had significantly higher QPA. We found 10°<LPT to be a cut-off value to cause SL-Hoffa fat pad oedema.
The anatomical variations of the knee joint are associated with fat-pad, cartilage and tendon pathologies.
研究膝关节解剖变异与病变之间的关联，并描述股四头肌髌腱角（QPA）。
回顾性评估406例外侧髌股角（LPT）>5°患者的磁共振成像（MRI）以及40例LPT<5°的对照组患者的MRI。测量QPA、LPT、滑车沟角（TSA）、胫骨结节-滑车沟距离（TT-TG）、Insall-Salvati指数（ISI）、髌腱长度（PTL）、髌骨高度（PH）、外侧滑车倾斜度（LTI）、滑车小面不对称率（TFA）和滑车深度（TD）。评估脂肪垫水肿、髌骨和滑车软骨软化、髌腱和股四头肌肌腱病以及积液的存在情况。
患者组的TSA、PTL、ISI和TT-TG中位数显著更高；LTI、TFA和TD显著更低。患者组中SL-Hoffa、非SL-Hoffa、髌上和股前脂肪垫水肿、积液和软骨软化的患病率显著更高。发现LPT与TSA和TT-TG呈正相关，与LTI和TD呈负相关。滑车发育不良、髌骨软骨软化和股四头肌肌腱病的病例LPT显著更高。QPA与TSA呈正相关，与LTI呈负相关。滑车发育不良、非SL-Hoffa水肿、股前脂肪垫水肿和股四头肌肌腱病的病例QPA显著更高。我们发现LPT>10°是导致SL-Hoffa脂肪垫水肿的临界值。
膝关节的解剖变异与脂肪垫、软骨和肌腱病变有关。
