Summary
Patella height is significantly associated with functional knee scores in patients with Kellgren-Lawrence stage 3 and 4 gonarthrosis, with higher patella height correlating negatively with knee function, guiding personalized treatment approaches.
Abstract
Aim
This orthopedic research aims to investigate the relationship between patella height and functional knee scores in individuals diagnosed with Kellgren-Lawrence stage 3 and 4 gonarthrosis. The primary objective is to discern if variations in patella height have a discernible impact on functional outcomes in this specific patient population.
Materials And Methods
A retrospective cohort study was conducted on a sample of Kellgren-Lawrence stage 3 and 4 gonarthrosis patients. 30 patients with stage 3 and 30 patients with stage 4 gonarthrosis were included in the study. Patella height measurements were obtained through standardized radiographic imaging, and functional knee scores, including range of motion, pain levels, and overall joint function, were assessed using Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS) and Visual Analog Scale (VAS). Statistical analyses, including correlation studies and subgroup comparisons, were performed to explore potential associations between patella height and functional outcomes.
Results
The average age of participants is 58.7 years, and 75% of them are female. The average age of the stage 4 gonarthrosis group is higher compared to the stage 3 group. Among the 30 patients with stage 3 gonarthrosis, 23 had an Insall-Salvati Ratio (ISR) below 1, while 7 had an ISR above 1.2. In the 30 patients with stage 4 gonarthrosis, 21 had an ISR above 1.2, and 9 had an ISR below 1. 28 participants had an ISR greater than 1.2. 32 participants had an ISR less than 1. As patella height increases, there is a rise in Kellgren-Lawrence stage (r = 0.72, p = 0.03) and VAS score (r = 0.72, p = 0.03), while the Knee Society Score (KSS) for both knee and functional scores (r = -0.75, p = 0.02) and KOOS score (r = -0.81, p < 0.001) decrease. When comparing stage 3 and stage 4 patients, ISR was found to be significantly higher in the stage 4 group (p = 0.02).
Conclusion
Our study presents compelling evidence supporting the negative impact of increasing patella height on functional knee scores in patients with Kellgren-Lawrence stage 3 and 4 gonarthrosis. Additionally, the significantly higher patella height in end-stage patients highlights the association between patella height and gonarthrosis. Recognizing this relationship may guide orthopedic practitioners in personalizing treatment strategies to address anatomical variations. Further research is required to elucidate the underlying biomechanical mechanisms and to confirm the potential clinical applicability of these findings in managing gonarthrosis patients at this specific stage of the disease.