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Chondral damage affects patellar mobility

Patellar tightness is directly correlated with patellofemoral chondral defects.

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Restricted patellar mobility is associated with chondral damage in the patellofemoral compartment, according to a study by researchers at the Steadman Hawkins Clinic in Vail, Colo.

Patellofemoral chondral defects can cause pain and, in some cases, disability. J. Richard Steadman, MD, and colleagues sought to determine whether there is an association between restricted mobility and chondral damage, and if so, its prominence. Steadman presented the results at the recent 6th Symposium of the International Cartilage Repair Society (ICRS) in San Diego.

Preoperatively, the researchers evaluated 410 knees between Nov. 2004 and Nov. 2005 and documented patellar tightness in the superior, inferior, medial and lateral positions. Fifty-two percent of patients were women and 48% were men.

“Forty-one percent of patients had patella tightness in at least one direction, 24% had patella tightness in all four directions, 9% had inferior and superior, 3% had medial and lateral,” Steadman said.

The study showed that 40% of patients had severe chondral damage to the patellofemoral compartment, 54% of the patients with patellar tightness had severe patellofemoral damage and 29% without tightness had significant patellofemoral chondral damage.

Based on these results, the authors drew an association between patellar tightness in any direction and severe chondral damage in the patellofemoral compartment. Patients with any amount of tightness were three times more likely to experience severe patellofemoral damage than those without tightness. Additionally, severe patellofemoral damage was three times more likely in patients with superior patellar tightness and was 2.4 times more likely in patients with inferior patellar tightness compared to patients without tightness.

The loss of patella mobility is a clear indication of a problem, Steadman said. Early signs of patellar tightness could be a risk factor for changes in the patellofemoral compartment.

For more information:

• Steadman JR, Briggs KK, Rodkey WG. Association between patellar mobility and patellofemoral chondral defects. #6-1. Presented at the 6th Symposium of the International Cartilage Repair Society. Jan. 8-11, 2006. San Diego.