Changes in femoral trochlear morphology following surgical correction of recurrent patellar dislocation associated with trochlear dysplasia in children

Fu, Kai; Duan, Guman; Liu, C; Niu, Jinghui; Wang, F

doi:10.1302/0301-620x.100b6.bjj-2017-1295.r1

Cited by 40 publications

(69 citation statements)

References 57 publications

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“…In the study group (Table 2), the patellar tilt angle (28.4 ± 7.1°) and congruence angle (22.8 ± 6.3°) before surgery decreased signi cantly at the last follow-up (patellar tilt angle: 10.7 ± 2.3°; congruence angle: 8.4 ± 2.6°). The sulcus angle in the study group (148.2 ± 7.2°) was signi cantly different from that at the last follow-up(144.1 ± 5.4°), which was consistent with the study by Fu [18].…”

Section: Resultssupporting

confidence: 90%

“…Benoit et al [17] reported that children with recurrent patellar dislocation had a statistically signi cant improvement in the femoral sulcus angle after patellar stabilization procedure. Fu et al [18] found that the femoral trochlear morphology can be improved with lower trochlear groove angle and higher trochlear groove depth by early surgical correction in children with recurrent patellar dislocation associated with femoral trochlear dysplasia.…”

Section: Introductionmentioning

confidence: 99%

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The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

Niu

Hao

et al. 2020

Preprint

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Background: Although morphological improvement of femoral trochlea has been investigated in children with patellar dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patella morphology in transverse plane following surgical correction of recurrent patella dislocation in children.Methods: A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patella dislocation. The knees with recurrent patellar dislocation were treated with medial patellar retinaculum plasty and defined as the affected side. The contralateral knees with no symptom of patellar instability were considered as the unaffected side. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up.Results: There were not significant differences about patellar transverse diameter, thickness and Wiberg angle between affected side and unaffected side before surgery and at the last follow-up respectively ( The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the affected side (0.74 ± 0.06) was significantly different from that in the unaffected side (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the affected side (0.67 ± 0.05) and the unaffected side (0.65 ± 0.04) were not significantly different. Also, in the affected side, the Wiberg-index at the last follow-up was significantly lower than that before surgery (P < 0.05). The Wiberg-index in the unaffected side was not significantly different before surgery and at the last follow-up. Conclusion: The patella morphology can change significantly after surgical procedures in children with patellar recurrent dislocation whose epiphysis is not closed.

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Section: Resultssupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

Niu

Hao

et al. 2020

Preprint

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“…On the other hand, the patella and femoral trochlea dysplasia can occur after patella dislocation [14,15,16]. This study and the study by Fu [18] showed signi cant morphological alteration of patella and femoral trochlea after surgical correction in the children with recurrent patella dislocation. So the development of the patella and femoral trochlea was thought to be effected on both congenital factors and acquired factors, especially the engagement between patella and femoral trochlea.…”

Section: Discussionsupporting

confidence: 51%

“…Combined with the previous study [14,15,16,18], the normal patella position with femoral trochlea is important for the patellofemoral development. Patellar and femoral trochlear dysplasia can occur after patella dislocation [14,15].…”

Section: Discussionmentioning

confidence: 74%

The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

Niu

Hao

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Although morphological improvement of femoral trochlea has been investigated in children with patella dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patella morphology in transverse plane following surgical correction of recurrent patella dislocation in children.Methods: A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patella dislocation. The knees with recurrent patella dislocation were treated with medial patellar retinaculum plasty and defined as the study group. The contralateral knees with no symptom of patellar instability were considered as the control group. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up.Results: There are not significant differences about patellar transverse diameter, thickness and Wiberg angle between study group and control group before surgery and at the last follow-up respectively ( The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the study group (0.74 ± 0.06) is significantly different from that in the control group (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the study group (0.67 ± 0.05) and the control group (0.65 ± 0.04) are not significantly different. Also, in the study group, the Wiberg-index at the last follow-up is significantly lower than that before surgery (P ＜ 0.05). The Wiberg-index in the control group is not significantly different before surgery and at the last follow-up. Conclusion: The patella morphology can change significantly after surgical procedures in children (before epiphyseal closure) with patellar recurrent dislocation

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“…Animal studies have found that abnormal mechanical stress (patellar subluxation or instability) may lead to patellofemoral TD and patellofemoral osteoarthritis. However, both animal and clinical investigations have revealed that early restoration of the patella can minimize such dysplasia. Therefore, the development of the femoral trochlea may not only be determined by genetics, but may also be altered by acquired conditions.…”

Section: Discussionmentioning

confidence: 99%

Changes in Cartilage and Subchondral Bone of Femoral Trochlear Groove After Patellectomy in Growing Rabbits

Wang

et al. 2020

Orthopaedic Surgery

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Objective: To explore the effects of patellectomy on the bony and cartilaginous morphology of the trochlear groove in growing rabbits.Methods: Forty-eight 4-week-old New Zealand white rabbits were randomly assigned to two groups. The control group underwent a sham surgical procedure, whereas the patellectomy group underwent patella excision surgery. Half of the rabbits in each group were sacrificed 3 months postoperatively; the rest were sacrificed 6 months postoperatively. Hematoxylin and eosin staining was performed on collected samples. Measurements included the bony and cartilaginous sulcus angles of the trochlear groove. In addition, the thickness of the articular cartilage at the deepest sulcus position (central thickness) and at the mid-position of the medial and lateral facets was measured and compared between groups.Results: Three months after surgery, histological images revealed significant differences between the control group and the patellectomy group in cartilaginous sulcus angle (144.2 AE 1.5 vs 151.9 AE 2.4 , respectively; P < 0.001). No obvious difference in bony sulcus angle was found between the groups. Six months after surgery, significant between-group differences were observed in cartilaginous sulcus angle (136.3 AE 2.5 in control group vs 160.7 AE 3.0 in patellectomy group, P < 0.001) and bony sulcus angle (136.2 AE 2.2 in control group vs 160.4 AE 2.6 in patellectomy group, P < 0.001). However, there were no significant intra-group differences between cartilaginous and bony sulcus angles in either group. Three months after surgery, significant between-group differences were detected in articular cartilage thickness at the three different positions (medial facet: 324.3 AE 14.0 μm in control group vs 391.7 AE 98.8 μm in patellectomy group, P = 0.029; central position: 362.1 AE 13.6 μm in control group vs 730.3 AE 76.8 μm in patellectomy group, P < 0.001; lateral facet: 324.6 AE 12.7 μm in control group vs 358.5 AE 38.7 μm in patellectomy group, P = 0.009). No between-group differences in cartilage thickness were found at 6 months.Conclusions: Abnormal mechanical stress (patellectomy) during a rabbit's development can cause flattening of the femoral trochlear cartilage, followed by changes in the subchondral osseous layer. Abnormal mechanical stress is a crucial factor in the development of trochlear groove dysplasia.

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Changes in femoral trochlear morphology following surgical correction of recurrent patellar dislocation associated with trochlear dysplasia in children

Abstract: The femoral trochlear morphology can be improved by early (before epiphyseal closure) surgical correction in children with recurrent patellar dislocation associated with femoral trochlear dysplasia. Cite this article: Bone Joint J 2018;100-B:811-21.

Cited by 40 publications

References 57 publications

The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

Changes in Cartilage and Subchondral Bone of Femoral Trochlear Groove After Patellectomy in Growing Rabbits

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