Effect of Trochlear Dysplasia on Outcomes After Isolated Soft Tissue Stabilization for Patellar Instability

Hiemstra, Laurie A.; Kerslake, Sarah; Loewen, Michael; Lafave, Mark R.

doi:10.1177/0363546516635626

Cited by 86 publications

(79 citation statements)

References 50 publications

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“…The salient finding of the present study is that the mean TA showed a significant positive correlation with Dejour type from B to D. Many studies have recommended that severe trochlear dysplasia should be corrected by a tracheloplasty procedure for long-term patellar stability [ 15 – 19 ]. Several investigators have deemed severe trochlear dysplasia to be a significant negative prognostic risk factor for other procedures performed without managing trochlear dysplasia [ 20 ]. With the advancement of surgical techniques and instruments, the trochleoplasty, aiming to restore the normal anatomy of trochlea and patellar stability, is increasingly popular.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

et al. 2018

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BackgroundTrochlear dysplasia is an important pathological factor in patellofemoral instability. Quantitative evaluation of the severity of trochlear dysplasia is rare and remains unclear.Material/MethodsComputed tomography (CT) data on 136 knees (95 patients) with trochlear dysplasia in the case group and an age- and sex-matched cohort of 120 knees (70 patients) in the control group were collected for this retrospective study. All participants had undergone CT scans in the supine position. The trochlear angles (TA) formed by the posterior condylar line and the trochlear line were calculated and compared. The threshold for statistical significance was set at p<0.05.ResultsThe mean TA values were significantly greater in the case group compared to the control group independent of sex (p<0.01). The distribution of trochlear dysplasia of Dejour grades was type A n=34, type B n=31, type C n=40, and type D n=31. Except for types A and B, differences in the trochlear dysplasia grade between any 2 other types were statistically significant (p<0.01).ConclusionsThe technique of measuring TA is reproducible and accurate in patients with patellar instability and normal controls. The TA positively correlates with higher levels of trochlear dysplasia. This technique can help to evaluate and treat trochlear dysplasia in research as well as in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

et al. 2018

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“…71 In patients with severe trochlear dysplasia, procedures like tibial tubercle transfer and MPFL reconstruction, which address other underlying bone and soft tissue abnormalities, are still fairly successful; nevertheless, recurrent dislocation rates are lower when these procedures are combined with reshaping of the trochlea (trochleoplasty) in this patient group. 72,73 Although one of the earliest operations described for patellofemoral instability was designed to elevate the lateral trochlea, 74 trochleoplasty has only recently come back in favor. Bone is removed from beneath the trochlear groove to deepen it, or a new superior trochlear groove is fashioned by removal of an excessive superior trochlear ridge.…”

Section: Trochleoplastymentioning

confidence: 99%

Postoperative Imaging of the Knee Extensor Mechanism

Long

Rubin

2018

Semin Musculoskelet Radiol

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The extensor mechanism of the knee plays an important role in many movements of the lower extremity. Although its main function is to extend the knee, it also stabilizes the patellofemoral joint and resists passive flexion of the knee when landing from jumping. Pathologic conditions of the extensor mechanism can be acute or chronic, and they can negatively affect daily activities. Fortunately, many surgical treatments are available aimed at restoring function to the injured extensor mechanism. Understanding the surgical techniques and common complications of these procedures enables the radiologist to recognize expected and unexpected postoperative imaging appearances.

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“…33 It is important to note that patients with conditions such as trochlear dysplasia or hyperplasia are at increased risk for patellofemoral instability, independent of the condition of the soft tissue stabilizers. 35…”

Section: Anatomy and Biomechanicsmentioning

confidence: 99%

Management of Injuries to the Medial Patellofemoral Ligament: A Review

et al. 2017

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The medial patellofemoral ligament (MPFL) is thought to be the most important medial structure providing restraint to lateral subluxation of the patella. After an initial patellar dislocation, the MPFL is frequently injured and can usually be treated with conservative measures. However, these patients often suffer from recurrent dislocations, which thereby necessitate operative intervention. In the setting of normal anatomy and kinematics, isolated reconstruction of the MPFL is an effective treatment for preventing recurrent dislocations. Various surgical techniques have been described, with differences in fixation and graft selection. The treatment of MPFL injuries should aim to provide patellar stabilization and restore normal kinematics throughout the joint. This review will discuss the following: (1) anatomy of the MPFL, (2) presentation and assessment of MPFL injuries, (3) management of patients with MPFL injuries, and (4) complications following MPFL reconstruction.

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Effect of Trochlear Dysplasia on Outcomes After Isolated Soft Tissue Stabilization for Patellar Instability

Cited by 86 publications

References 50 publications

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

Postoperative Imaging of the Knee Extensor Mechanism

Management of Injuries to the Medial Patellofemoral Ligament: A Review

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