Purpose: Trochlear dysplasia is one of the most important pathomorphologies predisposing to patellofemoral instability. The development of the trochlea groove is not well understood so far. We hypothesized that the underlying pathology of trochlear dysplasia is a medial hypoplasia.
Methods: 110 magnetic resonance imaging (MRI) scans from adult knees, 55 with and 55 without trochlear dysplasia were analyzed. On the axial and sagittal T2 MRI sequences, the height (h), width (w) and depth (d) of the medial (MC) and lateral femoral condyle (LC) as well as the depth of the trochlea groove (dTG) were measured using a three-dimensional measuring algorithm.
Results: For all calculated values of the lateral femoral condyle, the comparison of both groups showed no significant difference (p = 0.95, p = 0.11, p = 0.07). The depth of the trochlear groove (dTG) showed significant lower values in the study group (p < 0.05). In the study group, all measurements of the medial femoral condyle were statistically significantly smaller compared to the control group (p < 0.05).
Conclusions: We found that the height, the width and the depth of the medial condyle is significant smaller in patients with trochlea dysplasia than in healthy controls. The measurements of the lateral femoral condyle showed no significant difference. Patients with a dysplastic trochlea have a hypoplastic medial femoral condyle and a more medially placed trochlea groove compared to controls.
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http://dx.doi.org/10.1007/s00402-019-03233-4 | DOI Listing |
Knee Surg Sports Traumatol Arthrosc
January 2025
Sports Medicine Service, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Purpose: To propose a new sign of patellar maltracking in recurrent patellar dislocation (RPD) and compare the differences in lower limb rotational and bony structural abnormalities among the different signs.
Patients And Methods: A retrospective study included 279 patients (mean age: 22 years; female: 81%) who underwent primary surgery for RPD over the past 4 years was performed. The patients were grouped based on the characteristics of patellar tracking: low-, moderate- and high-grade J-sign.
J ISAKOS
January 2025
University of Virginia Health System, Department of Orthopaedic Surgery, Charlottesville, VA, USA.
Purpose: To update previously published clinical and radiographic outcomes of Dejour sulcus-deepening trochleoplasty and medial patellofemoral ligament reconstruction (MPFL-R), at mid-term follow-up, and monitor trends in patient reported outcome scores and satisfaction.
Methods: Using the same cohort of patients from our previously published short-term series of 2-year follow up, interval follow-up was performed on 67 patients (76 knees) with severe trochlear dysplasia and recurrent patellar instability who were prospectively enrolled and underwent Dejour sulcus-deepening trochleoplasty and MPFL-R combined with other patellar-stabilization procedures. Patients with less than 2-year follow-up were excluded.
Purpose: Tibial rotational deformity is a known risk factor for patellofemoral joint (PFJ) disorders. However, it is commonly associated with other abnormalities which affect the PFJ. The purpose of this study was to describe the prevalence of associated factors known to affect PFJ in patients undergoing rotational tibial osteotomy and their implication for the correction level.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA 98105, USA.
Patellar pathologies are a common cause of knee dysfunction, with Patellofemoral Pain Syndrome (PFPS) alone responsible for 25% of knee-related visits to sports medicine clinics. Non-traumatic conditions, while often overlooked, can also lead to significant discomfort and functional limitations, highlighting the importance of accurate and timely diagnosis for effective management and prevention of complications. This pictorial review examines the radiologic characteristics of various non-traumatic patellar disorders, focusing on imaging modalities such as radiography, computed tomography (CT), and magnetic resonance imaging (MRI).
View Article and Find Full Text PDFBackground: Medial patellofemoral ligament reconstruction (MPFLR) is an excellent surgical option for patients with recurrent patellar instability. This technique has demonstrated significant improvements in patient-reported outcomes, high rates of return to sport, and low rates of failure. However, there is debate regarding the use of isolated MPFLR in the setting of concomitant pathoanatomic features such as patella alta, trochlear dysplasia, or a lateralized tibial tubercle.
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