Abstract
Purpose
To investigate the morphometry of patellar tendon with magnetic resonance imaging (MRI) and to reveal the relation between patellar tendon properties and anterior knee pain (AnKP).
Methods
Twenty-three patients with AnKP and nine healthy individuals were included in the study. Patients with knee anomaly that may cause AnKP were excluded from the study. The patellar tendon examination was performed on sagittal and coronal sections of MRI. Freehand technique was used to frame the area of tendon and calculations were done by generic software.
Results
There were 23 patients in AnKP (+) and 9 individuals in AnKP (−) group. The morphometric results were not different among groups (p = 0.2). Higher body mass index was correlated with increased patellar tendon surface area in women (R 2 = 0.37).
Conclusion
Patellar tendon length, thickness and surface area do not seem as a significant parameter to explain the aetiology of AnKP. Given the well-defined role of patellar tendon to support knee kinetics, the clinical value of tendon morphometry is to be determined.
Similar content being viewed by others
References
Ahmad CS, Kwak SD, Ateshian GA, Warden WH, Steadman JR, Mow VC (1998) Effects of patellar tendon adhesion to the anterior tibia on knee mechanics. Am J Sports Med 26:715–724
Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the American rheumatism association. Arthritis Rheum 29:1039–1049
Asano H, Muneta T, Ikeda H, Yagishita K, Kurihara Y, Sekiya I (2004) Arthroscopic evaluation of the articular cartilage after anterior cruciate ligament reconstruction: a short-term prospective study of 105 patients. Arthroscopy 20:474–481
Bonnet CS, Walsh DA (2005) Osteoarthritis, angiogenesis and inflammation. Rheumatology (Oxford) 44:7–16
Brown JA, Brophy RH, Franco J, Marquand A, Solomon TC, Watanabe D, Mandelbaum BR (2007) Avoiding allograft length mismatch during anterior cruciate ligament reconstruction: patient height as an indicator of appropriate graft length. Am J Sports Med 35:986–989
Dye SF (2005) The pathophysiology of patellofemoral pain: a tissue homeostasis perspective. Clin Orthop Relat Res 436:100–110
Fairbank JC, Pynsent PB, van Poortvliet JA, Phillips H (1984) Mechanical factors in the incidence of knee pain in adolescents and young adults. J Bone Joint Surg Br 66:685–693
Freedman KB, D’Amato MJ, Nedeff DD, Kaz A, Bach BR Jr (2003) Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 31:2–11
Fulkerson JP (2002) Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 30:447–456
Gobbi A, Mahajan S, Zanazzo M, Tuy B (2003) Patellar tendon versus quadrupled bone-semitendinosus anterior cruciate ligament reconstruction: a prospective clinical investigation in athletes. Arthroscopy 19:592–601
Grelsamer RP (2000) Patellar malalignment. J Bone Joint Surg Am 82-A:1639–1650
Hayes CW (1994) MRI of the patellofemoral joint. Semin Ultrasound CT MR 15:383–395
Kaplan N, Wickiewicz TL, Warren RF (1990) Primary surgical treatment of anterior cruciate ligament ruptures. A long-term follow-up study. Am J Sports Med 18:354–358
Kartus J, Movin T, Karlsson J (2001) Donor-site morbidity and anterior knee problems after anterior cruciate ligament reconstruction using autografts. Arthroscopy 17:971–980
Kartus J, Movin T, Papadogiannakis N, Christensen LR, Lindahl S, Karlsson J (2000) A radiographic and histologic evaluation of the patellar tendon after harvesting its central third. Am J Sports Med 28:218–226
McNally EG (2001) Imaging assessment of anterior knee pain and patellar maltracking. Skeletal Radiol 30:484–495
Muellner T, Kaltenbrunner W, Nikolic A, Mittlboeck M, Schabus R, Vecsei V (1998) Shortening of the patellar tendon after anterior cruciate ligament reconstruction. Arthroscopy 14:592–596
O’Brien SJ, Warren RF, Pavlov H, Panariello R, Wickiewicz TL (1991) Reconstruction of the chronically insufficient anterior cruciate ligament with the central third of the patellar ligament. J Bone Joint Surg Am 73:278–286
Oliveria SA, Felson DT, Reed JI, Cirillo PA, Walker AM (1995) Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum 38:1134–1141
Paulos LE, Wnorowski DC, Greenwald AE (1994) Infrapatellar contracture syndrome. Diagnosis, treatment, and long-term followup. Am J Sports Med 22:440–449
Pinar H (2004) Anterior knee pain in the absence of patellofemoral instability. Acta Orthop Traumatol Turc 38:108–118
Schweitzer ME, Mitchell DG, Ehrlich SM (1993) The patellar tendon: thickening, internal signal buckling, and other mr variants. Skeletal Radiol 22:411–416
Shin CS, Chaudhari AM, Dyrby CO, Andriacchi TP (2009) Influence of patellar ligament insertion angle on quadriceps usage during walking in anterior cruciate ligament reconstructed subjects. J Orthop Res 27:730–735
Suri S, Gill SE, Massena de Camin S, Wilson D, McWilliams DF, Walsh DA (2007) Neurovascular invasion at the osteochondral junction and in osteophytes in osteoarthritis. Ann Rheum Dis 66:1423–1428
Svensson M, Kartus J, Ejerhed L, Lindahl S, Karlsson J (2004) Does the patellar tendon normalize after harvesting its central third? A prospective long-term MRI study. Am J Sports Med 32:34–38
Ververidis A, Verettas D, Kazakos K, Xarchas K, Drosos G, Psillakis I (2009) Anterior cruciate ligament reconstruction: outcome using a patellar tendon bone (ptb) autograft (one bone block technique). Arch Orthop Trauma Surg 129:323–331
Yoo JH, Yi SR, Kim JH (2007) The geometry of patella and patellar tendon measured on knee MRI. Surg Radiol Anat 29:623–628
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tuncyurek, O., Ozkol, M., Ozic, U. et al. The role of patellar tendon morphometry on anterior knee pain. Surg Radiol Anat 32, 539–543 (2010). https://doi.org/10.1007/s00276-009-0610-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-009-0610-z