Extensor mechanism tendinopathy in patients with lateral patellar maltracking

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Patellar maltracking is a significant component of patellofemoral pain syndrome.
• Repetitive patellar stabilization attempts in maltracking may lead to extensor mechanism dysfunction.

Purpose of the Study:

• To identify imaging features indicative of patellar maltracking.
• To determine which maltracking patients are at risk for extensor mechanism tendinopathy.

Main Methods:

• Retrospective review of 218 knee MRIs for anterior knee pain with maltracking findings.
• Evaluation of patellar and quadriceps tendinopathy, TT-TG distance, and chondrosis.
• Comparison with 100 age-matched healthy control MRIs.

Main Results:

• Maltracking patients with tendinosis were younger (41.2 vs. 48.2 years).
• Significantly higher TT-TG distance (16.49 mm vs. 14.99 mm) in maltrackers with tendinosis.
• Extensor mechanism tendinosis was more prevalent in maltrackers (57.8% vs. 27.3%).

Conclusions:

• Extensor mechanism tendinosis is more common and occurs at a younger age in patellar maltracking.
• Elevated TT-TG distance is associated with extensor mechanism dysfunction and isolated lateral patellofemoral chondrosis.
• TT-TG measurement is a valuable independent predictor for identifying maltrackers at risk of complications.