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Can Ellipsoid Sign be One of the Earliest Findings of the Medial Femoral Condyle Chondromalacia of Knee Antero Posterior X-Ray?

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Abstract

Background/purpose of the study

Aim of the study was to investigate whether ellipsoid sign (ES) in the region corresponding to the cartilaginous facet of the medial femoral condyle (MFC) indicates early cartilage lesion. The finding has not been defined in the literature yet.

Methods

The study was performed retrospectively with 50 patients who underwent articular cartilage examination and arthroscopy between 2015 and 2018. Patients were divided into two according to the presence or absence of ES. There were 24 patients in case group (Group A) and 26 patients in controls (Group B). Weight-bearing cartilage areas of MFC in the region where ES was found in both groups were classified according to arthroscopic Outerbridge classification (OC) and compared statistically with each other.

Results

There was no significant difference in terms of age, gender and alignment between Group A and Group B (p > 0.05). All OC grades were higher in Group A (p  <  0.001). Positive correlation between ES and MFC chondromalacia grade was detected (r: 0.671, t: 6.266, p < 0.05).

Conclusion

ES, which refers to the difference in bone density in MFC seen in antero-posterior (AP) X-Ray, is a result of changes in subchondral bone due to chronic cartilage loss. ES detected on AP X-Ray may help in early diagnosis of medial femoral articular cartilage chondromalacia, even at grade 0 or 1. We recommend searching for ES, as the earliest symptom of chondromalacia, which occurs even before MRI lesions. Future studies may reveal additional information about ES.

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Acknowledgements

No source of support in the form of grants, equipment, drugs, or all of these were used in our study. There are no conflicts of interest. All authors contributed to the study. The manuscript has been read and approved by all the authors. The manuscript represents honest work.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Health Sciences University, Istanbul Bagcilar Research and Training Hospital, Merkez mh Mimar Sinan Cd, 34200, Bagcilar, Istanbul, Turkey

    Sever Çaglar

  2. Department of Orthopaedics and Traumatology, Health Sciences University, Istanbul Baltalimani Bone Diseases Research and Training Hospital, Baltalimani Hisar Cd, Sariyer, Istanbul, Turkey

    Cem Albay

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  1. Sever Çaglar
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  2. Cem Albay
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Contributions

SC contributed to the study by collecting the data and writing the manuscript. CA contributed to the manuscript by collecting the data and literature, and as the corresponding author.

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Correspondence to Cem Albay.

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All authors approved the manuscript and all authors declare that are no conflicts of interest regarding the publication.

Ethical standard statement

The current study was approved by the local ethic committee.

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The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Çaglar, S., Albay, C. Can Ellipsoid Sign be One of the Earliest Findings of the Medial Femoral Condyle Chondromalacia of Knee Antero Posterior X-Ray?. JOIO 54, 518–525 (2020). https://doi.org/10.1007/s43465-020-00140-4

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  • DOI: https://doi.org/10.1007/s43465-020-00140-4

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