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Sharp margin of antero-inferior lateral femoral condyle as a risk factor for patellar tendon-lateral femoral condyle friction syndrome

  • Musculoskeletal
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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

Key Points

• 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.

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Abbreviations

AUC:

Area under the curve

CI:

Confidence interval

ICCs:

Intraclass correlation coefficients

LFCA:

Lateral femoral condyle angle

LTH:

Lateral trochlear height

LTL:

Lateral trochlear length

MRI:

Magnetic resonance imaging

PLFFS:

Patellar tendon-lateral femoral condyle friction syndrome

ROC:

Receiver operating characteristic

SALFC:

Shape of antero-inferior part of lateral femoral condyle

SHFP:

Superolateral Hoffa’s fat pad

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Acknowledgments

The authors thank Dr. Li Ren, MD, for the statistical consultancy.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong Distract, Chongqing, 400016, People’s Republic of China

    Jia Li, Bo Sheng, Xin Liu, Fan Yu, Fajin Lv, Furong Lv & Haitao Yang

Authors
  1. Jia Li
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  2. Bo Sheng
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  3. Xin Liu
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  4. Fan Yu
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  5. Fajin Lv
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  6. Furong Lv
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  7. Haitao Yang
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Corresponding author

Correspondence to Haitao Yang.

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Guarantor

The scientific guarantor of this publication is Haitao Yang.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

Dr. Li Ren kindly provided statistical advice for this manuscript. No complex statistical methods were necessary for this paper.

Informed consent

Written or oral informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board’s approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in Haitao Yang, Skeletal Radiology, February 4, 2019 [Epub ahead of print].

Methodology

• retrospective

• observational

• performed at one institution

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Li, J., Sheng, B., Liu, X. et al. Sharp margin of antero-inferior lateral femoral condyle as a risk factor for patellar tendon-lateral femoral condyle friction syndrome. Eur Radiol 30, 2261–2269 (2020). https://doi.org/10.1007/s00330-019-06592-z

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  • DOI: https://doi.org/10.1007/s00330-019-06592-z

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