The role of viscosupplementation in patellar chondropathy

Patellar chondropathy has a high incidence in the general population, being more common in patients younger than 50 years, female and recreational athletes, and overweight and obese patients. The most common complaints are pain, limited mobility, crepitus, difficulty climbing and descending stairs, and joint instability, usually showing unsatisfactory results with anti-inflammatory, physiotherapy, rehabilitation, and many other conservative treatment methods. The presumed hyaluronic acid (HA) disease-modifying activity may include effects on cartilage degradation, endogenous HA synthesis, synoviocyte and chondrocyte function, and other cellular inflammatory processes. Currently, HA is widely used as a safe and effective conservative treatment for osteoarthritis in the knee and other joints. HA improves the physiological environment in an osteoarthritic joint and the shock absorption and lubrication properties of the osteoarthritic synovial fluid, thus restoring the protective viscoelasticity of the synovial HA, reducing the pain, and improving the mobility. The complete mechanism of HA in the joint is not fully understood, but a wide range of actions in the joint is recognized. Its anti-inflammatory, analgesic, and chondroprotective action is related to the modulation of the intra- and extracellular inflammation cascade. HA has been shown to be safe and effective in the treatment of pain related to patellar chondropathy.

Prevalence of patellar chondropathy on 3.0 T magnetic resonance imaging

Objective: To establish the prevalence of patellar chondropathy using 3T magnetic resonance imaging (MRI) and to correlate the findings with individual features such as gender, age, and body mass index. Materials and Methods: Data consisted of collecting 3T MRIs of patients’ knees obtained between October 2016 and September 2017, comprising a period of 12 months. These MRIs were assessed by an experienced musculoskeletal radiologist who confirmed the presence of patellar chondropathy and, when present, rated the finding into the four grades ascribed by the International Cartilage Repair Society. Results: A total number of 291 patients were assessed during the period with 389 MRI scans. Of those patients, 308 (79.2%) were diagnosed with patellar chondropathy, while 81 (20.8%) were not. Chondropathy was more prevalent in the female gender, in subjects above 40 years of age, and in obese patients. When the results were weighed in International Cartilage Repair Society classification, the milder grades (1 and 2) were seen in younger men (< 30 years of age), while the more severe grades (3 and 4) were mostly present in females, those above 40 years of age, and in obese patients. Conclusion: There was a high prevalence of patellar chondropathy in patients who had undergone high-field knee MRIs (79.2%), being highest in the female gender and in subjects above 40 years of age. The most prevalent group was graded as 4 by the International Cartilage Repair Society classification.