Victor Meissburger1, Grégoire Rougereau1, Tristan Langlais2,3, Philippe Boisrenoult1, Nicolas Pujol4. 1. Department of Orthopedic and Trauma Surgery, Centre Hospitalier de Versailles, André Mignot Hospital, Île-de-France Ouest University, 177 Rue de Versailles, 78150, Le Chesnay, France. 2. Department of Pediatric Orthopedics, Hôpital des enfants, Toulouse University, Purpan, 31059, Toulouse, France. 3. Department of Pediatric Orthopedics, Hôpital Armand-Trousseau, AP-HP, Sorbonne University, 26 avenue du Dr-Arnold-Netter, 75012, Paris, France. 4. Department of Orthopedic and Trauma Surgery, Centre Hospitalier de Versailles, André Mignot Hospital, Île-de-France Ouest University, 177 Rue de Versailles, 78150, Le Chesnay, France. npujol@ch-versailles.fr.
Abstract
PURPOSE: Patellar instability is a frequent clinical situation in adolescents and young adults. One of the most important risk factors of this condition is trochlea dysplasia. Few studies have analyzed the role of patellar dysplasia. The objective of this paper was to assess the correlation between trochlear and patellar dysplasia. The hypothesis is that patellar dysplasia increased in parallel with femoral trochlear dysplasia. METHODS: The study included patients operated on at least one knee for patellar instability between 2008 and 2020. For these patients, symptomatic knees (operated or not) were included if they had lateral and patellofemoral skyline radiographs. Two blinded observers categorized each trochlear and patellar dysplasia according to the Dejour and Wiberg classifications. Patellar height was also measured by applying the Caton-Deschamps index. RESULTS: A total of 100 patients were selected, involving 149 symptomatic knees. A significant correlation between trochlear and patellar dysplasia types was found (0.82; p < 0.0001). Dejour types B and C of trochlear dysplasia were significantly more often associated with patellar dysplasia than Dejour type A (p = 0.033 and p = 0.019, respectively). Moreover, severe Wiberg 3 patellar dysplasia was significantly associated with type D Dejour trochlear dysplasia than with the sum of all other Dejour types taken together (p < 0.0001). CONCLUSION: This study confirms a linear correlation between the severity of patellar and trochlear dysplasia. Further studies are needed to evaluate the place of patellar dysplasia in the therapeutic strategy. LEVEL OF EVIDENCE: Level IV.
PURPOSE: Patellar instability is a frequent clinical situation in adolescents and young adults. One of the most important risk factors of this condition is trochlea dysplasia. Few studies have analyzed the role of patellar dysplasia. The objective of this paper was to assess the correlation between trochlear and patellar dysplasia. The hypothesis is that patellar dysplasia increased in parallel with femoral trochlear dysplasia. METHODS: The study included patients operated on at least one knee for patellar instability between 2008 and 2020. For these patients, symptomatic knees (operated or not) were included if they had lateral and patellofemoral skyline radiographs. Two blinded observers categorized each trochlear and patellar dysplasia according to the Dejour and Wiberg classifications. Patellar height was also measured by applying the Caton-Deschamps index. RESULTS: A total of 100 patients were selected, involving 149 symptomatic knees. A significant correlation between trochlear and patellar dysplasia types was found (0.82; p < 0.0001). Dejour types B and C of trochlear dysplasia were significantly more often associated with patellar dysplasia than Dejour type A (p = 0.033 and p = 0.019, respectively). Moreover, severe Wiberg 3 patellar dysplasia was significantly associated with type D Dejour trochlear dysplasia than with the sum of all other Dejour types taken together (p < 0.0001). CONCLUSION: This study confirms a linear correlation between the severity of patellar and trochlear dysplasia. Further studies are needed to evaluate the place of patellar dysplasia in the therapeutic strategy. LEVEL OF EVIDENCE: Level IV.
Authors: Elias Ammann; Rahel L Meier; Erich Rutz; Patrick Vavken; Kathrin Studer; Carlo Camathias Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-03-04 Impact factor: 4.342
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Authors: Sandro F Fucentese; Andreas von Roll; Peter P Koch; Devakara R Epari; Bruno Fuchs; Philip B Schottle Journal: Knee Date: 2006-02-09 Impact factor: 2.199