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Patella-patellar tendon angle decreases in patients with infrapatellar fat pad syndrome and medial patellar plica syndrome

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Acknowledgments

We thank Rebecca Tollefson, DVM, from Edanz Group and Springer nature author services for editing a draft of this manuscript.

Funding

This work was supported by research fund of Chungnam National University Hospital.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Munhwa-dong, Jung-gu, Daejeon, 301-721, South Korea

    Young Mo Kim, Yong Bum Joo, Woo Yong Lee, Il Young Park & Young Cheol Park

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  1. Young Mo Kim
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Correspondence to Yong Bum Joo.

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The study was approved by the Chungnam National University Institutional Review Board (No. CNUH 2018-07-055).

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Kim, Y.M., Joo, Y.B., Lee, W.Y. et al. Patella-patellar tendon angle decreases in patients with infrapatellar fat pad syndrome and medial patellar plica syndrome. Knee Surg Sports Traumatol Arthrosc 28, 2609–2618 (2020). https://doi.org/10.1007/s00167-020-05892-y

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