The Value of Radiolographic Assessment in Patellofemoral Pain Syndrome

ABSTRACT

Patellofemoral pain syndrome (PFS) is one of the most common types of anterior knee pain and many studies reported the patellofemoral malalignments (such as high patella, increased sulcus angle and increased congruence angle) as possible causes of the syndrone. In order to confirm this hypothesis, the difference of congruence, sulcus angles and patella height ratio in normal subjects and PFS patients was evaluated. The PFS subjects were selected according to the criterias of anterior knee pain, pain aggravation after the repeated knee flexion and extension motion. A combined knee injury was screened by MRI. We have compared our data to the previous studies of Merchant et al.(1974), Aglietti et al.(1983), and Dowd and Bently(1986). The radiographic studies were done on lateral view, Merchant view, and patella height was measured by Insall-Salvati method and Blackburn-Peel method. The sulcus angle and the congruence angle were measured on a Merchant view. The results showed that the average patella height of normal group was 1.00+/-0.17 by the Insall test and the patella index was 1.02?0.23. There was no statistical difference between normal and patient group of which the patella height was 0.96+/-0.16 by Insall test with patella index of 1.04?0.17. On Merchant view, the congruence angle was +/-7 +/-11 degrees, and the sulcus angle was 135.5+/-6 degrees in PFS patient group, and in normal group the congruence angle was +/-2 +/-14 degrees, and the sulcus angle was 136+/-5. A little statistical variation was noted in both group. Our results were not much different from previous studies except for the Aglietti's study in congruence angle. We concluded that the Insall test, patella index, congruence angle and sulcus angle could not help to idetify patellofemoral malalignment of knee joint in PFS patients.