Quantitative magnetic resonance imaging in patellar tendon-lateral femoral condyle friction syndrome: relationship with subtle patellofemoral instability

  • Jia Li
  • Bo Sheng
  • Fan Yu
  • Chunhua Guo
  • Fajin Lv
  • Furong Lv
  • Haitao YangEmail author
Scientific Article



To investigate the correlation of patellar tendon-lateral femoral condyle friction syndrome (PTLFCFS) with subtle patellofemoral instability to explore its pathogenesis.

Materials and methods

One hundred knees of 80 patients with PTLFCFS were analyzed retrospectively by retrieving magnetic resonance imaging (MRI) data over a 3-year period from our database. Seven quantitative parameters for evaluating patellofemoral stability were measured on MR images, including the Insall–Salvati ratio, tibial tuberosity–trochlear groove (TT–TG) distance, trochlear groove depth, medial trochlear/lateral trochlear length (MT/LT) ratio, medial trochlear/lateral trochlear height (MH/LH) ratio, lateral patellofemoral angle (LPA), and lateral trochlear inclination (LTI) angle. These patellofemoral parameters of the PTLFCFS group and the normal control group were compared (n = 88), and receiving-operator characteristic (ROC) curve analysis was conducted to determine the specificity and sensitivity of these parameters.


The trochlear depth, MT/LT, LPA, and LTI angle were significantly lower (p < 0.001) and the Insall–Salvati ratio was significantly higher (p < 0.001) in the PTLFCFS group. However, the TT–TG distance and MH/LH ratio showed no significant difference (p = 0.231 and 0.073 respectively). The area under the ROC curve of the Insall–Salvati ratio, trochlear depth, MT/LT, LPA, and LTI angle were 0.925, 0.784, 0.8, 0.731, and 0.675 respectively. The efficiency of the Insall–Salvati ratio was the highest among those five parameters.


This study verified the presence of subtle patellofemoral instability by measuring various patellofemoral parameters in patients with PTLFCFS. It confirmed that PTLFCFS is associated with subtle patellofemoral instability and could largely explain the pathogenesis of PTLFCFS.


Knee joint Magnetic resonance imaging Patellar tendon Hoffa’s fat-pad edema Patellofemoral instability 


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


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Copyright information

© ISS 2019

Authors and Affiliations

  • Jia Li
    • 1
  • Bo Sheng
    • 1
  • Fan Yu
    • 1
  • Chunhua Guo
    • 1
  • Fajin Lv
    • 1
  • Furong Lv
    • 1
  • Haitao Yang
    • 1
    Email author
  1. 1.Department of RadiologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina

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