Sulcus Angle, Trochlear Depth, and Dejour’s Classification Can Be Reliably Applied To Evaluate Trochlear Dysplasia: A Systematic Review of Radiological Measurements

Saccomanno, Maristella F.; Maggini, Emanuele; Vaisitti, Niccolò; Pianelli, Antonio; Grava, Giuseppe; Cattaneo, Stefano; Milano, Giuseppe

doi:10.1016/j.arthro.2022.08.039

Cited by 14 publications

(10 citation statements)

References 57 publications

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“…1 ). According to the Dejour classification of trochlear dysplasia [ 25 ], 65 patients are with sever trochlear dysplasia (Type B-D). The ICC values for the intra-observer reliability of each measurement are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Evaluating the reliability of the lateral femoral condyle measuring methods by different modalities for patients with lateral patellar dislocation

Zhou,

Yu,

et al. 2024

BMC Musculoskelet Disord

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Background A variety of measurement methods and imaging modalities are in use to quantify the morphology of lateral femoral condyle (LFC), but the most reliable method remains elusive in patients with lateral patellar dislocation (LPD). The purpose of this study was to determine the intra- and inter-observer reliability of different measurement methods for evaluating the morphology of LFC on different imaging modalities in patients with LPD. Methods Seventy-three patients with LPD were included. Four parameters for quantifying the morphology of LFC were retrospectively measured by three observers on MRI, sagittal CT image, conventional radiograph (CR), and three-dimensional CT (3D–CT). The intra-class correlation coefficient was calculated to determine the intra- and inter-observer reliability. Bland–Altman analysis was conducted to identify the bias between observers. Results The lateral femoral condyle index (LFCI) showed better intra- and inter-observer reliability on MRI and 3D–CT than on CR and sagittal CT images. The mean difference in the LFCI between observers was lowest on 3D–CT (0.047), higher on MRI (0.053), and highest on sagittal CT images (0.062). The LFCI was associated with the lateral femoral condyle ratio (ρ = 0.422, P = 0.022), lateral condyle index (r = 0.413, P = 0.037), and lateral femoral condyle distance (r = 0.459, P = 0.014). The LFCI could be reliably measured by MRI and 3D–CT. Conclusion The LFCI could be reliably measured by MRI and 3D–CT. The LFCI was associated with both the height and length of LFC and could serve as a comprehensive parameter for quantifying the morphology of LFC in patients with LPD.

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Section: Resultsmentioning

confidence: 99%

Evaluating the reliability of the lateral femoral condyle measuring methods by different modalities for patients with lateral patellar dislocation

Zhou,

Yu,

et al. 2024

BMC Musculoskelet Disord

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“…The sulcus angle and trochlear depth were measured on the first axial MRI slice showing both medial and lateral trochlear cartilaginous facets [22]. The trochlear depth was calculated by subtracting the length of the trochlear groove from the mean of the length of the medial and lateral trochlear cartilaginous facets, with the PCRL as a reference line to measure the length.…”

Section: Methodsmentioning

confidence: 99%

Lateral trochlear inclination measured by the transepicondylar axis holds potential for evaluating trochlear dysplasia in patients with lateral patellar dislocation

Chen,

Li,

Feng

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose To verify that lateral trochlear inclination (LTI) measured by the transepicondylar axis can reliably be used to evaluate trochlear dysplasia (TD) on MRI and can serve as an objective indication of trochleoplasty for patients with lateral patellar dislocation (LPD). Methods Eighty patients with recurrent LPD and eighty healthy subjects were included. TD, posterior condylar angle (PCA), and LTI measured by the posterior condylar reference line (LTIp), surgical transepicondylar axis (LTIs), and anatomical transepicondylar axis (LTIa) were assessed on MRI. The intraclass correlation coefficient (ICC) and Bland-Altman analysis were performed, the correlations and differences amongst the parameters were identified, and a binary logistic regression model was established. Results Each measurement had excellent inter-and intra-observer agreement. The LTIp, LTIs and LTIa were smaller in the study group than in the control group, with mean differences of 9.0°, 7.2° and 7.0°, respectively (P < 0.001). The PCA was larger in patients with LPD than in the control group (P < 0.001). LTIp was associated with PCA in the study group (r = − 0.41, P < 0.001). The pathological values of LTIp, LTIs and LTIa were 11.7°, 15.3° and 17.4°, respectively. LTIs and LTIa were independent risk factors for LPD, with ORs of 7.33 (95% CI [1.06-52.90], P = 0.048) and 10.29 (95% CI [1.38-76.96], P = 0.023), respectively. Conclusion The LTI can be reliably measured by MRI, but LTIp could potentially decrease the recorded value from the actual inclination angle. LTIs and LTIa are more appropriate to serve as trochleoplasty indications for patients with LPD, which could help orthopedists with surgical decision-making. Level of evidence Level III.

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“…Trochlear dysplasia was evaluated by an experienced senior surgeon according to Dejour's classification using both true lateral radiographs and CT images [3, 23]. Type A trochlea was defined as low‐grade dysplasia, and types B, C, and D were defined as high‐grade dysplasia [16].…”

Section: Materials and Methodsmentioning

confidence: 99%

Distal femoral torsion is correlated with higher‐grade trochlear dysplasia and shorter anterior condyles in patients with patellar dislocation and increased femoral torsion

Hao,

Niu,

Huo

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose To describe the characteristics of femoral torsion in patients with different segmental torsion types and to evaluate the correlations between segmental torsion and the morphology of the femoral condyles and trochlea in patients with patellar dislocation and increased femoral torsion. Methods Between January 2021 and March 2023, 69 patients were included and classified into two groups according to the femoral segment contributing the most to total torsion: 32 patients in Group A (femoral neck and shaft torsion) and 37 patients in Group B (distal torsion). Trochlear dysplasia was evaluated using Dejour's classification and sulcus angle. The morphology of the femoral condyles was evaluated using the lengths and ratios of the medial and lateral condyles. Correlations between femoral torsion and morphology were evaluated. Results Total torsion was significantly correlated with femoral neck and shaft torsion (r = 0.882, P < 0.001) and distal torsion (r = 0.262, P = 0.030). Femoral neck and shaft torsion was significantly increased with increasing total torsion. The trochlear sulcus was flatter and more dysplastic, and the anterior condyles were shorter in Group B. Distal torsion was significantly correlated with the lengths of the medial and lateral anterior condyles (r = − 0.567, P < 0.001; r = -0.701, P < 0.001), sulcus angle (r = 0.611, P < 0.001) and Dejour trochlea type (r = 0.512, P = 0.001), while femoral neck and shaft torsion showed no correlations. Conclusion Femoral torsion is a complex of femoral neck and shaft torsion and distal torsion, especially femoral neck and shaft torsion. Distal torsion was significantly correlated with a flatter trochlear sulcus, higher-grade trochlear dysplasia, and shorter anterior condyles. The new findings highlighted the importance of the segmental evaluation of femoral torsion, which would facilitate understanding of the anatomical characteristics of femoral torsion in patients with patellar dislocation and increased femoral torsion and may lead to improvement in the surgical options regarding femoral torsion. Level of evidence Level III.

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Sulcus Angle, Trochlear Depth, and Dejour’s Classification Can Be Reliably Applied To Evaluate Trochlear Dysplasia: A Systematic Review of Radiological Measurements

Cited by 14 publications

References 57 publications

Evaluating the reliability of the lateral femoral condyle measuring methods by different modalities for patients with lateral patellar dislocation

Evaluating the reliability of the lateral femoral condyle measuring methods by different modalities for patients with lateral patellar dislocation

Lateral trochlear inclination measured by the transepicondylar axis holds potential for evaluating trochlear dysplasia in patients with lateral patellar dislocation

Distal femoral torsion is correlated with higher‐grade trochlear dysplasia and shorter anterior condyles in patients with patellar dislocation and increased femoral torsion

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