Andreas Voss1, Sangmin Ryan Shin2, Akira M Murakami3, Mark P Cote4, Andrea Achtnich5, Elmar Herbst5, Anthony A Schepsis6, Cory Edgar7. 1. Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany; Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, United States. 2. Southeast Permanente Medical Group, Kaiser Permanente, Atlanta, GA, United States. 3. Department of Radiology, Boston University Medical Center, Boston, MA, United States. 4. Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, United States; Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany. 5. Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany. 6. Coastal Orthopedics, Beverly, MA, United States. 7. Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT, United States. Electronic address: coedgar@uchc.edu.
Abstract
BACKGROUND: Trochlear dysplasia is an important risk factor associated with patellofemoral instability, but it remains difficult to classify with consistency. Currently there is no objective way to quantify the dysplasia. The purpose of this study is to define and quantify objectively the trochlear morphology by volume and length via computed tomography (CT). METHODS: One-hundred control patients (136 knees) were retrospectively reviewed and compared to 36 consecutive patients (72 knees) who were treated surgically for recurrent patellar instability and known trochlear dysplasia based on a lateral radiograph. Trochlear morphology was analyzed from a pre-operative CT and data presented as trochlear sulcus volume trochlear length. To determine where along the trochlear length dysplasia is most variable, the trochlear length was radiographically divided into thirds, volume was quantified along that section and compared to control trochlear. RESULTS: A significant difference in trochlear morphology exists between cohorts, volume (1.98 vs 3.77cm3) and length (31.97 vs 34.66mm) (p<0.05). However, there appears to be a gender based difference in trochlea morphology. The trochlea volumetric analysis between the female cohorts (L: 2.02cm3 vs. 2.94cm3, R: 1.95cm3 vs. 2.93cm3) demonstrated significantly less volume in instability patients (p<0.001). The proximal third of the trochlear contributed the majority of dysplasia difference determined by comparing mean trochlear volume, 95% of the difference. This difference decreased in distal sections, 53% and 32% respectively. CONCLUSION: This reproducible technique can be used to quantify the trochlea morphology, in order to describe the severity of a dysplasia.
BACKGROUND:Trochlear dysplasia is an important risk factor associated with patellofemoral instability, but it remains difficult to classify with consistency. Currently there is no objective way to quantify the dysplasia. The purpose of this study is to define and quantify objectively the trochlear morphology by volume and length via computed tomography (CT). METHODS: One-hundred control patients (136 knees) were retrospectively reviewed and compared to 36 consecutive patients (72 knees) who were treated surgically for recurrent patellar instability and known trochlear dysplasia based on a lateral radiograph. Trochlear morphology was analyzed from a pre-operative CT and data presented as trochlear sulcus volume trochlear length. To determine where along the trochlear length dysplasia is most variable, the trochlear length was radiographically divided into thirds, volume was quantified along that section and compared to control trochlear. RESULTS: A significant difference in trochlear morphology exists between cohorts, volume (1.98 vs 3.77cm3) and length (31.97 vs 34.66mm) (p<0.05). However, there appears to be a gender based difference in trochlea morphology. The trochlea volumetric analysis between the female cohorts (L: 2.02cm3 vs. 2.94cm3, R: 1.95cm3 vs. 2.93cm3) demonstrated significantly less volume in instability patients (p<0.001). The proximal third of the trochlear contributed the majority of dysplasia difference determined by comparing mean trochlear volume, 95% of the difference. This difference decreased in distal sections, 53% and 32% respectively. CONCLUSION: This reproducible technique can be used to quantify the trochlea morphology, in order to describe the severity of a dysplasia.
Authors: Tzu-Chieh Liao; Hannah Jergas; Radhika Tibrewala; Emma Bahroos; Thomas M Link; Sharmila Majumdar; Richard B Souza; Valentina Pedoia Journal: J Orthop Res Date: 2020-10-05 Impact factor: 3.102
Authors: Alex E White; Peters T Otlans; Dylan P Horan; Daniel B Calem; William D Emper; Kevin B Freedman; Fotios P Tjoumakaris Journal: Orthop J Sports Med Date: 2021-05-20