International Journal of Scientific Research in Dental and Medical Sciences

International Journal of Scientific Research in Dental and Medical Sciences

Evaluation of the Correlation between Chondromalacia Patellae and the Thickness of Subcutaneous Knee fat using Magnetic Resonance Imaging

Document Type : Original Article

Authors
Department of Radiodiagnosis, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Surathkal, Karnataka, India
Abstract
Background and aim: Chondromalacia Patellae is a condition that involves softening and degeneration of the articular hyaline cartilage of the Patellae that articulates with the trochlear groove of the femur. To evaluate the correlation between subcutaneous fat thickness around the knee joint with the presence or absence of chondromalacia Patellae/severity of chondromalacia Patellae in MRI.
Material and methods:  A retrospective review were conducted of knee MRIs in 100 patients referred to the department of radiodiagnosis for MRI imaging of the knee. The assessment was done for the presence or absence of chondromalacia Patellae and graded positive studies from 0 (absent) to 3(full cartilage thickness defect). Measurement of subcutaneous knee fat thickness was obtained on the medial, lateral, and prepatellar aspects of the knee.
Results: The subcutaneous thickness values were significantly different between patients with or without chondromalacia Patellae.  Mean values of normal and patients with chondromalacia Patellae vary with severity. The proportionate increase in the subcutaneous fat thickness values is observed with higher grades of chondromalacia Patellae.  Mean subcutaneous fat thickness values were seen to be on the higher side in female patients compared to male patients.
Conclusions: This is the first study to evaluate the correlation between subcutaneous knee fat thickness in three aspects (medial, anterior, and lateral) of knee circumference and chondromalacia Patellae. The study shows a positive relationship between the subcutaneous knee fat thickness and chondromalacia Patellae. This indirectly indicates the role of obesity in the development of chondromalacia Patellae. This positive relationship can be crucial in spreading awareness and preventive care.
Keywords

Subjects


[1] Derek Armfield MD, Patrick J, McMahon MD. Current Diagnosis & Treatment in Sports Medicine. 2007.
[2] Sirik M, Uludag A. Assessment of the relationship between patellar volume and chondromalacia patellae using knee magnetic resonance imaging. Northern clinics of Istanbul. 2020;7(3):280-3. Htps://doi.org/10.14744/nci.2019.65882.
[3] Teichtahl AJ, Wluka AE, Wang Y, Hanna F, English DR, Giles GG, Cicuttini FM. Obesity and adiposity are associated with the rate of patella cartilage volume loss over 2 years in adults without knee osteoarthritis. Annals of the rheumatic diseases. 2009;68(6):909-13. https://doi.org/10.1136/ard.2008.093310.
[4] Habusta SF, Coffey R, Ponnarasu S, Mabrouk A, Griffin EE. Chondromalacia patella. Stat Pearls Publishing; 2023.
[5] Markhardt BK, Huang BK, Spiker AM, Chang EY. Interpretation of cartilage damage at routine clinical MRI: how to match arthroscopic findings. Radiographics. 2022;42(5):1457-73. https://doi.org/10.1148/rg.220051.
[6] Pihlajamäki HK, Kuikka PI, Leppänen VV, Kiuru MJ, Mattila VM. Reliability of clinical findings and magnetic resonance imaging for the diagnosis of chondromalacia patellae. JBJS. 2010;92(4):927-34. https://doi.org/10.2106/JBJS.H.01527.
[7] Endo Y, Schweitzer ME, Bordalo-Rodrigues M, Rokito AS, Babb JS. MRI quantitative morphologic analysis of patellofemoral region: lack of correlation with chondromalacia patellae at surgery. American Journal of Roentgenology. 2007 Nov;189(5):1165-8. https://doi.org/10.2214/AJR.07.2236.
[8] Duran S, Çavuşoğlu M, Elverici E, Günaydın E. Kondromalazik Patella İle Diz Subkutan Yağ Kalınlığı Arasındaki Korelasyon: Manyetik Rezonans Görüntüleme Çalışması. Sakarya Tıp Dergisi. 2015;5(3):125-9. https://doi.org/ 10.5505/sakaryamj.2015.03360.
[9]Thomas M. Link. Cartilage Imaging. (2011-04-06) ISBN:9781441984388.
[10] Dursun M, Ozsahın M, Altun G. Prevalence of chondromalacia patella according to patella type and patellofemoral geometry: a retrospective study. Sao Paulo Medical Journal. 2022;140(6):755-61. https://doi.org/10.1590/1516-3180.2021.0206.R2.10012022.
[11] Öğüt E, Kabakcı AG, Saygılı H, Bozkır MG. Morphometric analysis of chondromalacia patella and patella types. Journal of Medicine and Palliative Care. 2023;4(6):663-71. https://doi.org/10.47582/jompac.1377942.
[12] Zheng W, Li H, Hu K, Li L, Bei M. Chondromalacia patellae: current options and emerging cell therapies. Stem Cell Research & Therapy. 2021;12:412. https://doi.org/10.1186/s13287-021-02478-4.
[13] Berry PA, Wluka AE, Davies-Tuck ML, Wang Y, Strauss BJ, Dixon JB, Proietto J, Jones G, Cicuttini FM. The relationship between body composition and structural changes at the knee. Rheumatology. 2010;49(12):2362-9. https://doi.org/10.1093/rheumatology/keq255.
[14] Anandacoomarasamy A, Smith G, Leibman S, Caterson I, Giuffre B, Fransen M, Sambrook P, March L. Cartilage defects are associated with physical disability in obese adults. Rheumatology. 2009;48(10):1290-3. https://doi.org/10.1093/rheumatology/kep246.
[15] Kok HK, Donnellan J, Ryan D, Torreggiani WC. Correlation between subcutaneous knee fat thickness and chondromalacia patellae on magnetic resonance imaging of the knee. Canadian Association of Radiologists Journal. 2013;64(3):182-6. https://doi.org/10.1016/j.carj.2012.04.003.
[16] Ostojic M, Hakam HT, Lovrekovic B, Ramadanov N, Prill R. Treatment of anterior knee pain due to chondromalacia patellae with platelet-rich plasma and hyaluronic acid in young and middle-aged adults, a cohort study. Archives of Orthopaedic and Trauma Surgery. 2024:1-8. https://doi.org/10.1007/s00402-024-05363-w.
 
Volume 6, Issue 3
Summer 2024
Pages 106-113

  • Receive Date 18 July 2024
  • Revise Date 20 August 2024
  • Accept Date 28 August 2024
  • Publish Date 02 September 2024