Patella-patellar tendon angle decreases in patients with infrapatellar fat pad syndrome and medial patellar plica syndro
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Patella‑patellar tendon angle decreases in patients with infrapatellar fat pad syndrome and medial patellar plica syndrome Young Mo Kim1 · Yong Bum Joo1 · Woo Yong Lee1 · Il Young Park1 · Young Cheol Park1 Received: 30 August 2019 / Accepted: 29 January 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose 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. Methods 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. Results 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. Conclusion 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 of evidence Level IV. Keywords Infrapatellar fat pad syndrome · Medial patellar plica syndrome · Magnetic resonance imaging · Patella–patellar tendon angle · Sagittal patellar tilt
Introduction * Yong Bum Joo [email protected] Young Mo Kim [email protected] Woo Yong Lee [email protected] Il Young Park [email protected] Young Cheol Park [email protected] 1
Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Munhwa‑dong, Jung‑gu, Daejeon 301‑721, South Korea
The reported prevalence of anterior knee pain (AKP) is as high as 22 cases per 1000 person-years [7, 37]. Although the causes of AKP vary, most AKP is related to patellofemoral joint (PFJ) structures. The anterior knee joint consists of cartilage, subchondral bone, the infrapatellar fat pad (IPFP), synovial plicae, retinacula, the joint capsule, and tendons. These structures act on or in combination with each other to cause AKP [7, 38]. Two conditions that are well-known
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