Does anterior cruciate ligament deficiency affect patellar orientation? A cross-sectional observational study

Anterior cruciate ligament (ACL) injury causes significant changes in the arthro-kinematics of the knee joint, affecting the patella-femoral joint (PFJ) and PFJ pain. This study aimed to observe changes in the orientation of the patella relative to the trochlear groove of the femur and to assess the incidence of PFJ pain following ACL injury.

This Cross-sectional observational study included 58 individuals aged 18 to 50 with ACL deficiency who had been injured for more than three months. Clinical and radiological parameters of the patella-femoral joint (PFJ) were recorded, with the uninjured limb as the control. Data was collected and analyzed using SPSS software.

PFJ pain was present in 25 (43 %) participants. The radiographic measurements (CD index, congruence angle, and patellar tilt) on the ACL deficient side showed no significant difference compared to their asymptomatic side. The mean difference in the CD index of the unloaded and loaded knee was 0.02 and 0.03, respectively. The congruence angle measurement in the ACL deficient knee was -2.27 ± 10.34, while the normal side was -4.44 ± 7.66. The lateral patellar angle measurement in the ACL deficient knee was 14.62 ± 4.77, while the normal side was 14.87 ± 5.06°.

Based on radiographic measurements, this study observed that ACL deficiency does not alter the patellar orientation but can result in PFJ pain.

Level IV.