Kondromalazi Patella Tanılı Hastalarda Patellofemoral Uyum ile Diz Ekleminin Fonksiyonelliği Arasındaki İlişki

Amaç: Kondromalazi patella, anterior diz ağrısı ile karakterize olan patellar kartilaj dejenerasyonudur. Bu çalışmada anterior diz ağrısı ile polikliniğimize başvuran ve manyetik rezonans görüntüleme ile kondromalazi patella (KMP) tanısı koyduğumuz hastalarda patellofemoral uyum ile diz fonksiyonelliği arasındaki ilişki değerlendirildi. Araçlar ve Yöntem: Çalışmamız tek merkezli kesitsel çalışma olarak dizayn edildi. Hastaların sosyodemografik özellikleri kaydedildi. Çalışmamız 36 hastanın 48 diz manyetik rezonans görüntülemesi (MRG) üzerinde gerçekleştirildi. Hastalar; Modifiye Outerbridge skalasına göre dört evreye, erken (Evre 1-2) ve ileri evre KMP (Evre 3-4) olarak iki gruba ayrıldı. Hastaların fizik muayene bulguları (Clark testi, patellar kompresyon testi, patellar tilt testi, J bulgusu), fonksiyonellik düzeyleri (WOMAC) ve MRG görüntüleme parametreleri değerlendirildi. Bulgular: Gruplar arası kıyaslamada ileri evre grubunun yaş ortalaması ve ağrı süresi istatistiksel olarak anlamlı düzeyde yüksekti (p<0,001). MRG parametrelerinde gruplar arası farklılık tespit edilmedi (p>0.05). Erken evre grubunda 3 hastada patella alta, 5 hastada patella baja, ileri evre grubunda 4 hastada patella alta, 4 hastada patella baja tanısı konuldu. Fonksiyonellik parametreleri kıyaslandığında ileri evre grubunda, erken evre grubuna kıyasla istatistiksel olarak anlamlı düzeyde yükseklik tespit edilmiştir (p<0,001).Sonuç: KMP hastalarında ileri evrelerde hastaların fonksiyonelliği azalmaktadır. MRG parametreleri, erken evre ve ileri evre KMP hastaları arasında farklılık göstermemiştir. Patellofemoral eklemde subjektif yakınmalarla, klinik ve görüntüleme bulguları korelasyon göstermediğinden bu konuda daha geniş popülasyonun dahil olduğu çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

fizik muayene, kondromalazi patella, manyetik rezonans görüntüleme

The Association Between Patellofemoral Congruance and Functionality of the Knee Joint in Patients with Chondromalacia Patella

Purpose: Chondromalacia patella (CMP) is characterized by anterior knee pain with patellar degeneration. Our study was undertaken to assess the association between patellofemoral congruence and knee functionality in patients with anterior knee pain who were diagnosed with CMP based on magnetic resonance imaging. (MRI)Materials and methods: The study was designed as a single-center, cross-sectional study. The sociodemographic of the patients were recorded. 36 patients with 48 knee MRI examinations were involved and grouped based on the Modified Outer bridge Grading system: Early-stage (Stage 1-2) and advanced-stage CMP (Stage 3-4). Physical exam findings (Clark’s test, patellar compression test, patellar tilt test, J sign), level of functionality (WOMAC), and MRI parameters were evaluated. Results: The mean age and duration of the pain were significantly higher in patients with advanced stage CMP (p > 0.05) (Table 3). The two groups did not differ in terms of Insall-Salvati index and patellar translation (p > 0.05). Patella alta and patella baja were detected in 3 and 5 patients with early-stage CMP and in 4 and 4 patients with advanced-stage CMP respectively. (p < 0.001). Conclusion: Advanced stage CMP is associated with reduced functionality. However, patients with early or advanced stage CMP did not differ significantly with regard to MRI. Since clinical and imaging findings are not correlated with subjective complaints regarding patellofemoral joint, studies involving larger populations are warranted.

Keywords:

Patellar chondromalacia, magnetic resonance imaging, physical examination,

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