Exposure to live in geographically steep terrain decreases patella height and increases the incidence of patella baja

Abstract

Objectives: This study aims to investigate the effect of the geographical conditions on patellar height. Methods: Two different groups of the same society were created according to the geographical structures that people live in (fully rugged mountainous terrain Giresun and flat terrain Alanya). But the daily activities such as kneeling, praying, squatting or sitting with crossed legs were same culturally. The study included patients living and working in these areas, as their parents, throughout their lives. Knee MRI of patients who did not suffer anterior knee pain were retrospectively evaluated. The Insall-Salvati index (ISI) was calculated and the patella baja incidence rates were compared between regions using the Fisher’s exact test. Results: A total of 885 knee MRIs were evaluated. The mean ISI for all individuals was found significantly different with a mean of 0.946±0.141 in Giresun and 1.014±0.13 in Alanya (p<0.001). The incidence of patella baja for all individuals was 5% in Giresun and 2% in Alanya (p=0.01). Conclusion: Our findings suggested that as the inclination of the region gets steeper; the patella height decreases and the patella baja incidence rate increases. Living in steep sloped geographical structures may be relevant in the etiology of patella baja.