Correlation between Trochlear Dysplasia and Anterior Cruciate Ligament Injury

Abstract

PURPOSE. To evaluate the correlation between trochlear dysplasia and anterior cruciate ligament (ACL) injury METHODS. Magnetic resonance images (MRIs) of 95 knees in 54 males and 36 females aged 4 to 74 (mean, 28) years who had anterior knee pain and suspected ligamentous injury were reviewed. The MRIs were independently reviewed by 2 musculoskeletal radiologists on 2 occasions. According to the Dejour classification, trochlear dysplasia was classified into types A, B, C, and D. Intra-articular injuries/ disorders of the patients included patellofemoral osteoarthritis, chondromalacia patella, meniscal tears, and ligamentous injuries. Intra- and inter-observer variability was calculated. RESULTS. 58 of the knees had trochlear dysplasia, 38 of which were Dejour type A. The intra- and inter-observer variability was good to excellent (Kappa=0.76-1). ACL tear was the most common injury (n=13). No ACL injury occurred in patients without trochlear dysplasia. The odds of having sustained an ACL injury were 8.8 fold greater in Dejour type-A knees than in non-type-A knees (p=0.023). CONCLUSION. Dejour type-A trochlear dysplasia was associated with ACL injuries.

Patellofemoral joint is an under reported joint in MRI knee - A retrospective, cross-sectional study

“…2 ). Details of the classification are described elsewhere [2] , [3] . Of these 24 cases of TD, 18 were not reported and 3 of these had associated patellar subluxation.…”

Correlation between Trochlear Dysplasia and the Notch Index

“…1 The incidence of cruciate ligament injury is greater in patients with trochlear dysplasia. 2 The Dejour classification of trochlear dysplasia is reproducible. [3][4][5] Knees with a narrow notch (decreased notch index) are associated with a higher risk of cruciate ligament injury.…”

Commentary: Correlation between Trochlear Dysplasia and Anterior Cruciate Ligament Injury

“…In this issue, Botchu et al 10 review 95 MRIs of patients with anterior knee pain and suspected ligamentous injury. Classically, lateral radiographs were used to detect trochlear dysplasia and to correlate classification with the associated MRI appearances.…”

“…12 Botchu et al 10 report that ACL tears were the most common injury, and none occurred without trochlear dysplasia (Dejour type A ensued in 12 and type B in one). The authors highlight the importance of anatomic variants that may influence injury patterns.…”

“…11 This is important, as obtaining a pure lateral radiograph is often problematic; studies have shown that malalignment of even 5º can give false positives. 12 Botchu et al 10 report that ACL tears were the most common injury, and none occurred without trochlear dysplasia (Dejour type A ensued in 12 and type B in one). The authors highlight the importance of anatomic variants that may influence injury patterns.…”