Patellar Tracking: An Old Problem with New Insights

Watts, R.E.; Gorbachova, Tetyana; Fritz, Russell C.; Saad, Sherif S.; Lutz, A.M.; Kim, J.; Chaudhari, Akshay; Shea, Kevin G.; Sherman, Seth L.; Boutin, Robert D.

doi:10.1148/rg.220177

Cited by 8 publications

(3 citation statements)

References 74 publications

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“…Trochlear dysplasia is a known risk factor for patellar instability in adolescents, and studies have demonstrated abnormalities in the trochlear morphology of patients with patellar instability [1,24,31,32,36]. The bony restraint of the patellofemoral joint formed by the femoral trochlea and the patella is one of the main structures that prevents patellar dislocation.…”

Section: Introductionmentioning

confidence: 99%

Patients with trochlear dysplasia have dysplastic medial femoral epiphyseal plates

Kong,

Kang,

Niu

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose To investigate the growth of the epiphyseal plate in patients with trochlea dysplasia using a 3D computed tomography (CT)-based reconstruction of the bony structure of the distal femur. The epiphysis plate was divided into a medial part and a lateral part to compare their diferences in patients with trochlear dysplasia. Methods This retrospective study included 50 patients with trochlea dysplasia in the study group and 50 age-and sexmatched patients in the control group. Based on the CT images, MIMICS was used to reconstruct the bony structure of the distal femur. Measurements included the surface area and volume of the growth plate (both medial and lateral), the surface area and capacity of the proximal trochlea, trochlea-physis distance (TPD) (both medial and lateral), and height of the medial and lateral condyle. ResultsThe surface area of the medial epiphyseal plate (1339.8 ± 202.4 mm 2 vs. 1596.6 ± 171.8 mm 2 ), medial TPD (4.9 ± 2.8 mm vs. 10.6 ± 3.0 mm), height of the medial condyle (1.1 ± 2.5 mm vs. 4.9 ± 1.3 mm), and capacity of the proximal trochlear groove (821.7 ± 230.9 mm 3 vs. 1520.0 ± 498.0 mm 3 ) was signiicantly smaller in the study group than in the control group. A signiicant positive correlation was found among the area of the medial epiphyseal plate, the medial TPD, the height of the medial condyle and the capacity of the proximal trochlear groove (r = 0.502-0.638). ConclusionThe medial epiphyseal plate was dysplastic in patients with trochlea dysplasia. There is a signiicant positive correlation between the surface area of the medial epiphyseal plate, medial TPD, height of the medial condyle and capacity of the proximal trochlear groove, which can be used to evaluate the developmental stage of the trochlea in clinical practice and to guide targeted treatment of trochlear dysplasia. Level of evidence III.

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Section: Introductionmentioning

confidence: 99%

Patients with trochlear dysplasia have dysplastic medial femoral epiphyseal plates

Kong,

Kang,

Niu

et al. 2023

Knee surg. sports traumatol. arthrosc.

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“…In contrast to other analogous studies, where trochlear dysplasia was assessed using the Dejour method with low intra- and inter-observer reliability 20 , 36 . Furthermore, while the lengths of AMC and MTF did not independently influence the occurrence of OD, they did indicate the presence or severity of trochlear dysplasia 37 , 38 . Consequently, it is imperative to exercise vigilance in patients with APD, particularly in those exhibiting an elevated sulcus angle.…”

Section: Discussionmentioning

confidence: 69%

Exploring osteochondral damage patterns in acute patellar dislocation: insights into morphological associations and risk factors

Gao,

Wei,

Yang

2024

Sci Rep

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Osteochondral damage (OD) is a significant outcome following acute patellar dislocation (APD), yet the factors contributing to its susceptibility remain unclear. The primary objective of this study was to assess the association between demographic characteristics, patellofemoral (PF) joint morphology, and the occurrence of OD. A retrospective analysis identified 74 patients with APD who underwent treatment in our unit between 2019 and 2022. All patients received MRI within a week of injury to assess OD, subsequently categorized according to the injury pattern. The Caton-Deschamps index (CDI), tibial tuberosity-trochlear groove distance (TT-TG), lateral trochlear inclination (LTI), sulcus angle (SA), patellar width (PW), patellar thickness (PT), and femoral condyle geometry were calculated from the MRI scans and compared between groups. The findings revealed that OD predominantly manifested in the lateral femoral condyle (LFC) region and the medial patella (MP) region. In our patient cohort, this study identified a significant association between sulcus angle and the incidence of OD in both MP and LFC regions. Additionally, a significant correlation was discerned between skeletal maturity and the incidence of OD in the LFC region within demographic characteristics.

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“…Regarding second-level imaging, MRI is generally recommended when ligamentous injury is suspected. On the other hand, when bony damage is suspected (with possible presence of osteochondral loose bodies), a CT scan is more appropriate [ 36 ]. On this occasion, the orthopedic surgeon will assess the effects of the conservative treatment and explain the risk factors for recurrence to the patient by identifying and quantifying the principal factors of instability and the PISS score.…”

Section: Primary Dislocation: Follow-upmentioning

confidence: 99%

Framing Patellar Instability: From Diagnosis to the Treatment of the First Episode

Maggioni

Giorgino

Messina

et al. 2023

JPM

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The patellofemoral joint (PFJ) is a complex articulation between the patella and the femur which is involved in the extensor mechanism of the knee. Patellofemoral disorders can be classified into objective patellar instability, potential patellar instability, and patellofemoral pain syndrome. Anatomical factors such as trochlear dysplasia, patella alta, and the tibial tuberosity–trochlear groove (TT-TG) distance contribute to instability. Patellofemoral instability can result in various types of dislocations, and the frequency of dislocation can be categorized as recurrent, habitual, or permanent. Primary patellar dislocation requires diagnostic framing, including physical examination and imaging. Magnetic resonance imaging (MRI) is essential for assessing the extent of damage, such as bone bruises, osteochondral fractures, and medial patellofemoral ligament (MPFL) rupture. Treatment options for primary dislocation include urgent surgery for osteochondral fragments or conservative treatment for cases without lesions. Follow-up after treatment involves imaging screening and assessing principal and secondary factors of instability. Detecting and addressing these factors is crucial for preventing recurrent dislocations and optimizing patient outcomes.

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Patellar Tracking: An Old Problem with New Insights

Cited by 8 publications

References 74 publications

Patients with trochlear dysplasia have dysplastic medial femoral epiphyseal plates

Patients with trochlear dysplasia have dysplastic medial femoral epiphyseal plates

Exploring osteochondral damage patterns in acute patellar dislocation: insights into morphological associations and risk factors

Framing Patellar Instability: From Diagnosis to the Treatment of the First Episode

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