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Cartilage-bone mismatch in the dysplastic trochlea. An MRI study.
A L van Huyssteen1, M R G Hendrix, A J Barnett
1Department of Orthopaedic Surgery, Claremont Hospital, Main Road, Claremont 7708, South Africa. adriaanandjo@tiscali.co.za
The Journal of Bone and Joint Surgery. British Volume
|April 29, 2006
Summary
Trochlear dysplasia, a common cause of patellar instability, shows significant differences between bony and cartilaginous trochlear shapes. Magnetic resonance imaging (MRI) is crucial for surgical planning in these cases.
Area of Science:
- Orthopedics
- Radiology
- Anatomy
Background:
- Trochlear dysplasia is a key factor in symptomatic patellar instability.
- Understanding the interplay between bony and cartilaginous morphology is vital for diagnosis and treatment.
Purpose of the Study:
- To compare the bony and cartilaginous trochlear morphology in patients with trochlear dysplasia versus a control group.
- To evaluate the discrepancy between osseous and cartilaginous contours using MRI.
Main Methods:
- Retrospective review of MRI scans from 23 patients with trochlear dysplasia and 11 controls.
- Assessment of bony and cartilaginous trochlear morphology, including sulcus angles.
- Evaluation of inter- and intra-observer variability.
Main Results:
- A significant difference was observed between the mean bony sulcus angle (167.9°) and the mean cartilaginous sulcus angle (186.5°) in the dysplastic group (p < 0.001).
- In 98.7% of cases, the cartilaginous contour differed from the osseous contour, often exacerbating the abnormality.
- Cartilage morphology significantly altered the perceived trochlear shape.
Conclusions:
- The cartilaginous trochlear morphology significantly deviates from the underlying bony structure in patients with trochlear dysplasia.
- MRI is essential for accurately visualizing these morphological differences and aiding surgical planning.
- This detailed assessment can improve treatment strategies for patellar instability related to trochlear dysplasia.