2015 ISAKOS Biennial Congress ePoster #1926

Assessment of Brain Activity in Patients with Medial Patellofemoral Ligament Deficiency- Functional Magnetic Resonance Imaging Study

Masaru Kadowaki, MD, Izumo, Shimane JAPAN
Nobuyuki Kumahashi, MD, PhD, Izumo, Shimane JAPAN
Yuji Uchio, MD, PhD, Izumo, Shimane JAPAN
Department of Orthopaedic Surgery, Shimane University, Izumo, Shimane, JAPAN

FDA Status Not Applicable

Summary: Functional magnetic resonance imaging revealed that patellar instability may cause abnormal perception and anxiety in patients with medial patellofemoral ligament deficiency.

Abstract:

Introduction

Patellar instability with medial patellofemoral ligament (MPFL) deficiency often causes anxiety related to the knee joint. However, this mechanism remains unknown. The aim of this study is to reveal brain activity in patients with MPFL deficiency by functional magnetic resonance imaging (fMRI).
Patients & Method: Twelve patients with MPFL deficiency and seven healthy subjects (control) were included in the study. Brain activity during passive lateral stress to the patella was compared between the two groups using an fMRI technique (3.0-T scanner).
Result: Patients with MPFL deficiency had diminished activity in several sensorimotor cortical areas including the primary and secondary somatosensory areas and the angular gyrus. However, they exhibited increased activity in three areas: the insula, anterior cingulate cortex, and dorsolateral prefrontal cortex.

Discussion And Conclusion

Decreased activity in the somatosensory cortical areas in these patients suggested that MPFL may function as a mechanoreceptor against the lateral shift of the patella. In contrast, increased activity in the insula, anterior cingulate cortex, and dorsolateral prefrontal cortex may indicate anxiety or fear due to patellar instability is recognized as aversion which is similar phenomenon to chronic pain. In conclusion, patellar instability may cause abnormal perception and anxiety in patients with MPFL deficiency.