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MRI Quantitative Morphologic Analysis of Patellofemoral Region: Lack of Correlation with Chondromalacia Patellae at Surgery

¹ Department of Radiology, New York University, Hospital for Joint Diseases Orthopaedic Institute, New York, NY.
² Present address: Department of Radiology, State University of New York Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203.
³ Present address: Radiology Department, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, Brazil.
⁴ Department of Orthopaedic Surgery, New York University, Hospital for Joint Diseases Orthopaedic Institute, New York, NY.
⁵ Department of Radiology, New York University School of Medicine, New York, NY.

OBJECTIVE. In numerous studies, the morphologic features of the patellofemoral joint have been analyzed on radiographs. The objective of this study was to assess patellofemoral measurements on MR images and to correlate the measurements with the presence or absence of chondromalacia patellae confirmed at surgery.

MATERIALS AND METHODS. Axial and sagittal MR images of 98 knees (97 patients) were evaluated. Lateral and medial patellar facet lengths, lateral-to-medial facet length ratio, and interfacet angle were measured at three levels through the patella. Trochlear depth was measured on an axial slice. Patella and patellar tendon lengths, patellar tendon-to-patella ratio, and overlap of the patellar and trochlear articular cartilages were measured on sagittal slices. These measurements in knees with chondromalacia patellae were compared with those in knees without chondromalacia patellae. For assessment of reproducibility, axial measurements were repeated by a second observer.

RESULTS. There was no statistically significant difference in any of the axial and sagittal slice measurements between knees with and those without chondromalacia patellae. Interobserver reliability was excellent for measurements of trochlear depth and measurements in the superior and middle aspects of the patella. Measurements through the inferior patella were slightly less reproducible.

CONCLUSION. The results of our study with MRI confirmed many previous radiographic findings. Although we did not find correlation between the presence of chondromalacia patellae and the patellofemoral indexes we analyzed, it is possible that the results of further investigations incorporating different grades of chondromalacia and different locations along the patellar articular surface may lead to further insight regarding the morphologic risk factors for chondromalacia patellae.

Keywords: anatomy • chondromalacia patellae • patella • patellofemoral joint

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