Association Between Patellar Morphology and Chondromalacia Patellae: A Magnetic Resonance Imaging Study

Objective: Chondromalacia patellae (CP) is a common cause of anterior knee pain and is considered a multifactorial disorder involving mechanical, anatomical, and biomechanical factors. This study aimed to evaluate magnetic resonance imaging (MRI)-derived patellar morphological parameters in patients with and without CP. Methods: This retrospective single-center study included 889 patients who underwent knee MRI from January 2024 to May 2026. Patients were divided into two groups according to the presence or absence of MRI findings compatible with CP. The Wiberg classification, Wiberg index, Wiberg angle, and patellar linear dimensions were evaluated. Results: CP was detected in 278 patients (31.3%), while 611 patients (68.7%) constituted the non-CP group. No significant difference was observed in gender distribution between groups (P=0.151). The CP group was significantly younger than the non-CP group (40.15 ± 10.8 vs. 45.8 ± 12.4 years, P <0.001). The distribution of Wiberg patellar types differed significantly between groups (P=0.021), and type III morphology was more frequent in patients with CP. The Wiberg index was significantly lower in the CP group compared with the non-CP group (0.61 ± 0.08 vs. 0.73 ± 0.07, P <0.001). The anteroposterior diameter was significantly larger (21.18 ± 2.3 mm vs. 19.74 ± 2.1 mm, P <0.001), whereas the transverse diameter was significantly smaller in the CP group (40.33 ± 3.4 mm vs. 41.68 ± 2.9 mm, P <0.001). No significant difference in craniocaudal diameter was found between groups (P=0.137). Conclusion: Several MRI-derived patellar morphological parameters were independently associated with CP after adjustment for age and sex. These findings provide additional information regarding patellar morphology in patients with CP; however, further prospective studies incorporating clinical symptoms and outcomes are required to determine their value in routine MRI interpretation. © 2026 The Author(s). Published by Galenos Publishing House on behalf of the Turkish Society of Magnetic Resonance.