Can 3D ultrasound identify trochlea dysplasia in newborns? Evaluation and applicability of a technique

Kohlhof, Hendrik; Heidt, Christoph; Bähler, A.; Kohl, Sandro; Gravius, Sascha; Friedrich, M; Ziebarth, Kai; Stranzinger, Enno

doi:10.1016/j.ejrad.2015.03.015

Cited by 13 publications

(10 citation statements)

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“…Recent studies have suggested that trochlear dysplasia occurs early in development, possibly in utero. 10,14 This may suggest that trochlear dysplasia does not change significantly during the adolescent period when patients are reaching their peak growth rate. We therefore looked at all of our patients who had multiple MRIs (n ¼ 16; 10 unstable, 6 stable) to see how these measurements are changing as a function of age and skeletal maturity.…”

Section: Discussionmentioning

confidence: 99%

Are the Current Classifications and Radiographic Measurements for Trochlear Dysplasia Appropriate in the Skeletally Immature Patient?

Stepanovich

Bomar

Pennock

2016

Orthopaedic Journal of Sports Medicine

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Background:The assessment and classification of trochlear dysplasia in pediatric patients has yet to be well documented or validated.Purpose:To examine several different measurements/classifications of trochlear dysplasia in skeletally immature patients to assess inter- and intraobserver reliability and to determine which best correlates with patellar instability.Study Design:Cohort study (diagnosis); Level of evidence, 3.Methods:Radiographs and magnetic resonance imaging (MRI) scans of 36 skeletally immature patients undergoing surgery for patellar instability were compared with 27 age-matched cohort patients who had similar imaging for an acute knee injury but no clinical evidence of patellar instability. Trochlear dysplasia was measured/classified using the radiographic and MRI Dejour classifications, the trochlear depth index (TDI), the lateral trochlear inclination (LTI), and the medial condyle trochlear offset (MCTO). Additionally, the tibial tubercle–trochlear groove (TT-TG) distance was calculated for all patients. Inter- and intraobserver reliability of each measurement, as well as the ability to discriminate patients with patellar instability, were evaluated.Results:Inadequate radiographs prevented the radiographic Dejour classification from being assessed in 78% of cases. The MRI Dejour classification had the lowest inter- and intraobserver reliabilities (κ = 0.687 and 0.596, respectively); all other measurements were greater than 0.80. The TDI, LTI, and MCTO all significantly differentiated patients with patellar instability compared with those with no instability, with critical cutoffs of 3 mm, 17°, and 1 mm, respectively. Patients with a TDI <3 mm or MCTO <1 mm were 33 and 38 times more likely to have patellar instability, respectively. The TT-TG was directly correlated with trochlear dysplasia severity.Conclusion:Trochlear dysplasia is common in skeletally immature patients with patellar instability. The objective assessment of trochlear dysplasia with axial imaging MRI is reliable. The objective measurements of TDI, LTI, and MCTO are more reproducible than the more subjective Dejour classification. The TDI, LTI, and MCTO all significantly differentiated patients with patellar instability.

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Section: Discussionmentioning

confidence: 99%

Are the Current Classifications and Radiographic Measurements for Trochlear Dysplasia Appropriate in the Skeletally Immature Patient?

Stepanovich

Bomar

Pennock

2016

Orthopaedic Journal of Sports Medicine

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“…Trochlear dysplasia is recognized as a developmental condition of hereditary and congenital nature strongly in uenced by environmental factors such as hormone levels and mechanical stress on the patella [20]. Øye et al and Kohlhof et al reported trochlear dysplasia occurs in utero [21,22] and the study of Yrjänä N showed that trochlear cartilage develops as early as 9 weeks of gestation [8]. Henricson [11] reported that hip dysplasia could be induced by the administration of estradiol.…”

Section: Discussionmentioning

confidence: 99%

Changes in the femoral trochlear induced with estradiol exposure, an experimental study on rats

Zhou

et al. 2023

Preprint

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Background: It is well known that estrogen is closely related to bone and joint tissue. Findings indicate that estradiol, injected during pregnancy, passes through the placental barrier and reaches the fetuses in utero where it exerts its action. Since trochlea appears well established in the prenatal period, however, whether trochlear dysplasia is related to estradiol exposure has not been confirmed, and the pathological process of estradiol exposure-induced trochlear dysplasia remains unclear. This study aimed to establish an estradiol exposure animal model in fetuses and to analyze the morphology of the femoral trochlear in neonatal rats. Methods: 30 pregnant Wistar rats provided by the local Animal Center were assigned randomly into 3 groups, a high dose estradiol injection group, a low dose estradiol injection group and a blank control group. The pregnant rats in high dose group were intramuscular injected with estradiol benzoate, 200 μg/kg body weight, intramuscularly injected until the neonatal rats were born, and low dose group with 100 μg/kg body weight. Gross, cross-sectional observation and histological staining measurement of the rat offspring were conducted to evaluate the morphological changes of the femoral trochlea. Results: The incidence of trochlear dysplasia increased with the concentration of estradiol injection. Neonatal rats in the high dose group had the high prevalence of trochlea dysplasia (53 of 60), followed by low dose of trochlea dysplasia (49 of 60). Gross and cross-sectional observation showed a shallower trochlea groove in two groups with estradiol injection. Histological staining measurement indicated that the trochlear sulcus angle and trochlear sulcus depth were significantly different between the two groups with estradiol injection and the blank control group at 0,5 and 10 days after birth. Conclusion: In this study, estradiol exposure in fetuses had an adverse effect on intrauterine development and could induce trochlear dysplasia in rat offspring. In addition, this study also showed that the higher concentration of estradiol injection in pregnant rats, the more incidence of trochlear dysplasia in rat offspring.

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“…The surface morphology of the femoral trochlea has been reported to develop and take shape very early during growth [8,9,38]. Recently, Kohlhof et al [18] and Øye et al [27] reported that trochlear dysplasia occurs very early in development, perhaps even in utero. The breech position, especially the frank breech position, in which the knee of the fetus remains in the extended position, has been reported to be a major risk factor for the development of trochlear dysplasia [26].…”

Section: Introductionmentioning

confidence: 99%

Can Traditional Straight-leg Swaddling Influence Developmental Dysplasia of the Femoral Trochlea? An In Vivo Study in Rats

Wang

Liu

et al. 2022

Clin Orthop Relat Res

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Background It has been reported that trochlear dysplasia occurs very early in development, and environmental factors like swaddling may cause developmental dysplasia of the hip, which is associated with a shallower trochlear groove. However, to our knowledge, there are no definitive studies about the relationship between trochlear dysplasia and traditional straight-leg swaddling. Questions/purposes Using a rat model of femoral trochlear dysplasia, we asked: Does straight-leg swaddling for 1 and 2 weeks in newborn Wistar rats alter the femoral trochlea with respect to (1) gross morphology, (2) histologic appearance, as well as (3) trochlear sulcus angle, width, and depth? Methods Eighty-four newborn Wistar rats (44 females and 40 males) were divided into two equal groups: 42 in the

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Can 3D ultrasound identify trochlea dysplasia in newborns? Evaluation and applicability of a technique

Cited by 13 publications

References 13 publications

Are the Current Classifications and Radiographic Measurements for Trochlear Dysplasia Appropriate in the Skeletally Immature Patient?

Are the Current Classifications and Radiographic Measurements for Trochlear Dysplasia Appropriate in the Skeletally Immature Patient?

Changes in the femoral trochlear induced with estradiol exposure, an experimental study on rats

Can Traditional Straight-leg Swaddling Influence Developmental Dysplasia of the Femoral Trochlea? An In Vivo Study in Rats

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