Development of the femoral trochlear groove in rabbits with patellar malposition

Kaymaz, Burak; Atay, Özgür Ahmet; Ergen, Fatma Bilge; Mermerkaya, Musa Uğur; Olgun, Z. Deniz; Ateşok, Kıvanç; Doral, Mahmut Nedim

doi:10.1007/s00167-012-2163-7

Cited by 44 publications

(42 citation statements)

References 18 publications

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“…Kaymaz et al [11] studied 32 knees from 16 rabbits that were divided into an experimental group (patellar tendon Z-plasty lengthening for patella alta, 16 knees) and control group (no surgical interventions). The study demonstrated that the mean middle and distal trochlear groove angles in the experimental group were significantly higher and that the mean trochlear depths were significantly lower than those in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Li et al [9] and Wang et al [10] found femoral trochlear dysplasia or flattening after patella instability in growing rabbits. Kaymaz et al [11] demonstrated that the trochlea flattened after surgery with respect to the patella alta in growing rabbits. These studies indicate that femoral trochlea dysplasia could be caused by instability of the patella.…”

Section: Introductionmentioning

confidence: 99%

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Patella morphological alteration after patella instability in growing rabbits

Niu

et al. 2017

J Orthop Surg Res

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BackgroundThe shape of the patella has been considered to be a predisposing factor resulting in patellar instability, but the effects of abnormal patella position during its development are unclear. The present study evaluated patellar morphological changes after patella instability and evaluated the influence of patellar instability on the patella shape.MethodsTwenty rabbits that were 2 months old were included in the study. The left knee of each rabbit, defined as the experimental group (N = 20 knees/group), underwent a medial soft tissue restraint release. The right knee of each rabbit, defined as the control group (N = 20 knees/group), did not undergo any surgical procedures. A CT scan was performed on each knee before surgery and 6 months post-surgery to measure the transverse diameter, thickness, Wiberg index, and Wiberg angle for analysis of the patellar morphological changes. Cross-specimen examination was conducted to evaluate the differences between the experimental group and the control group.ResultsThe four indices remained the same between the two groups before surgery. However, 6 months after surgery, the mean transverse diameter of the patellae in the experimental group was significantly longer than that in the control group (P < 0.001), while the mean thickness in the experimental group was not significantly greater than that in the control group (P = 0.314), resulting in a flattened shape. The Wiberg indices were not significantly different between the two groups. However, the mean Wiberg angle was higher in the experimental group than in the control group (P < 0.001), which resulted in a flattened articular surface of the patella.ConclusionThe sectional shape and articular surface of the patella became more flattened after patella instability in this study, which indicates that patella dysplasia could be caused by patella instability. Clinically, early intervention for adolescent patients with patella instability is important.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patella morphological alteration after patella instability in growing rabbits

Niu

et al. 2017

J Orthop Surg Res

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“…This concept finds some confirmation in animal models, in which an artificially malpositioned patella during growth constrained physiological trochlear sulcus development in terms of depth when compared with controls. 9 …”

Section: Aetiology Of Dysplasiamentioning

confidence: 99%

The patellofemoral joint: from dysplasia to dislocation

et al. 2017

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Patellofemoral dysplasia is a major predisposing factor for instability of the patellofemoral joint. However, there is no consensus as to whether patellofemoral dysplasia is genetic in origin, caused by imbalanced forces producing maltracking and remodelling of the trochlea during infancy and growth, or due to other unknown and unexplored factors.The biomechanical effects of patellofemoral dysplasia on patellar stability and on surgical procedures have not been fully investigated. Also, different anatomical and demographic risk factors have been suggested, in an attempt to identify the recurrent dislocators. Therefore, a comprehensive evaluation of all the radiographic, MRI and CT parameters can help the clinician to assess patients with primary and recurrent patellar dislocation and guide management.Patellofemoral dysplasia still represents an extremely challenging condition to manage. Its controversial aetiology and its complex biomechanical behaviour continue to pose more questions than answers to the research community, which reflects the lack of universally accepted guidelines for the correct treatment. However, due to the complexity of this condition, an extremely personalised approach should be reserved for each patient, in considering and addressing the anatomical abnormalities responsible for the symptoms.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160081. Originally published online at www.efortopenreviews.org

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“…also reported that lateral patellar subluxation or instability (loss of restraint function of medial patellofemoral ligament) early in a rabbit's development caused femoral TD or flattening. Kaymaz et al . documented that simulated patella alta (patellar malposition) via patellar tendon Z‐plasty lengthening resulted in a flatter distal femoral groove.…”

Section: Introductionmentioning

confidence: 99%

“…TD is the malformation of the shape and depth of the femoral trochlear groove. Previous studies have demonstrated that loss of the soft tissues of the medial patella can lead to TD. Computed tomography has been used in some studies to evaluate the sulcus angle of the trochlear groove.…”

Section: Introductionmentioning

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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Development of the femoral trochlear groove in rabbits with patellar malposition

Abstract: Controlled laboratory study, Level II.

Cited by 44 publications

References 18 publications

Patella morphological alteration after patella instability in growing rabbits

Patella morphological alteration after patella instability in growing rabbits

The patellofemoral joint: from dysplasia to dislocation

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

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