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The patella morphology in trochlear dysplasia--a comparative MRI study.
Sandro F Fucentese1, Andreas von Roll, Peter P Koch
1Department of Orthopaedics, University of Zurich, Uniklinik Balgrist, Zurich, Switzerland.
The Knee
|February 17, 2006
Summary
Patellar morphology changes in trochlear dysplastic knees, with smaller overall size and medial facets, are linked to decreased medial patellofemoral traction, not just pressure. This impacts patellar instability.
Area of Science:
- Orthopedics
- Radiology
- Genetics
Background:
- Trochlear dysplasia, a condition with suspected genetic origins, leads to recurrent patellar instability due to abnormal knee anatomy.
- While trochlear morphology and surgical treatments are well-studied, patellar morphology in these cases remains underexplored.
Purpose of the Study:
- To evaluate and compare patellar morphology in knees with and without trochlear dysplasia.
Main Methods:
- Biometric analysis of 22 trochlear dysplastic knees (study group) and 22 normal knees (control group) using MRI.
- Comparison of parameters including diameter, cartilaginous thickness, Wiberg index and angle, facet lengths and radii, patellar shape and angle, and retropatellar length.
- Statistical analysis employed the Wilcoxon signed ranks test.
Main Results:
- Significant statistical differences were observed in transverse and sagittal diameters, medial patellar facet length, and mean cartilaginous and subchondral Wiberg index between the groups.
- While the femoral sulcus angle was larger in the dysplastic group, the Wiberg angle and index were comparable to the control group.
Conclusions:
- Patellar morphology exhibits changes in trochlear dysplasia, characterized by smaller overall size and medial facets.
- These findings suggest decreased medial patellofemoral traction, potentially due to hypotrophic medial restraints and increased lateral tilt, contributes to instability.
- The role of genetics in patellar morphology in this context requires further investigation.