MRI Measurements Associated with Patellofemoral Instability

Münch, J; Sullivan, Jaron P.; Nguyen, Joseph; Hillman, Andrew; Mintz, Douglas N.; Green, Daniel; Strickland, Sabrina; Stein, Beth Shubin

doi:10.1016/j.arthro.2015.04.069

Cited by 1 publication

(2 citation statements)

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“…Of the remaining 1,810, a further 1,743 were irrelevant based on their title and/or abstract. Full‐text screening of the remaining 67 eligible studies resulted in exclusion of 37 irrelevant studies [1–3, 5, 6, 8–11, 13, 14, 21, 23–25, 28, 29, 32, 33, 37, 38, 42, 44–46, 51, 55–57, 60, 61, 63, 66–70], five studies that did not report intra‐ or inter‐observer agreement [2, 35, 43, 52, 61], four studies that were conference proceedings [40, 49, 53, 59], two studies that assessed agreement for classification systems other than Dejour classification [34, 48], one study that included skeletally immature patients [15], two studies that expressed inter‐observer agreement only as a percentage [36, 64], three studies that were not in English or French [12, 39, 71] and three studies that could not be retrieved [7, 19, 47]. No additional studies were identified from reference lists, which left ten relevant studies for data extraction [4, 6, 22, 30, 31, 39, 41, 54, 58, 65].…”

Section: Resultsmentioning

confidence: 99%

“…, five studies that did not report intra-or inter-observer agreement [2,35,43,52,61], four studies that were conference proceedings [40,49,53,59], two studies that assessed agreement for classification systems other than Dejour classification [34,48], one study that included skeletally immature patients [15], two studies that expressed inter-observer agreement only as a percentage [36,64], three studies that were not in English or French [12,39,71] and three studies that could not be retrieved [7,19,47].…”

Section: Study Selectionmentioning

confidence: 99%

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Inconsistent repeatability of the Dejour classification of trochlear dysplasia due to the variability of imaging modalities: a systematic review

Pineda,

Müller,

Nover

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose The purpose of this systematic review was to critically assess the quality of papers that report on the intra-and inter-observer repeatability of the Dejour classification for trochlear dysplasia, and to identify the possible causes for poor repeatability. Methods Two authors independently conducted an electronic search (four databases) on 8 February 2023 for studies (English or French) that assessed trochlear dysplasia classifications on imaging of skeletally mature participants. Exclusion criteria were reviews of clinical studies, conference proceedings, or editorials. After title, abstract, and full-text screening, characteristics of eligible studies were tabulated (author, year, journal, study design, cohort characteristics, and intra-and/or interobserver agreement coefficients). The methodological quality of studies was assessed using the Joanna Briggs Institute (JBI) checklist for analytical cross-sectional studies. Authors analysed three components of the included studies: (1) classifications based on true lateral radiographs and slice imaging; (2) dysplasia graded into Type A vs B vs C vs D and 3) coefficients of intra-and/or inter-observer agreement. ResultsThe electronic search returned 3,178 references, and after removal of duplicates and irrelevant studies, ten were eligible for data extraction. A second search (31 July 2023) yielded one additional study. Eight studies did not include lateral radiographs, two studies did not explicitly state if radiographs were true lateral views, and one used true lateral radiographs in isolation. Classification of trochlear dysplasia into A vs B vs C vs D using different imaging modalities resulted in moderate to near-perfect intra-observer agreement, and slight to near-perfect inter-observer agreement. Studies distinguished between moderate and severe dysplasia using a variety of combinations: A vs B/C/D, A/B vs C/D and A/C vs B/D. Conclusion This systematic review revealed that the Dejour classification remains the most widely used to assess trochlear dysplasia and that the majority of studies that assessed the reliability of the Dejour classification, reported moderate to nearperfect inter-observer agreement; however, pooling of results for comparison among the included studies was inappropriate due to substantial variation in imaging protocols and non-standardised criteria to distinguish severe from moderate dysplasia. Level of evidence Level IV. Trial registryThe PROSPERO registration number is CRD42023386731.

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