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The severity of patellar and trochlear dysplasia are correlated

Knee Surgery, Sports Traumatology, Arthroscopy (2022)Cite this article

Abstract

Purpose

Patellar instability is a frequent clinical situation in adolescents and young adults. One of the most important risk factors of this condition is trochlea dysplasia. Few studies have analyzed the role of patellar dysplasia. The objective of this paper was to assess the correlation between trochlear and patellar dysplasia. The hypothesis is that patellar dysplasia increased in parallel with femoral trochlear dysplasia.

Methods

The study included patients operated on at least one knee for patellar instability between 2008 and 2020. For these patients, symptomatic knees (operated or not) were included if they had lateral and patellofemoral skyline radiographs. Two blinded observers categorized each trochlear and patellar dysplasia according to the Dejour and Wiberg classifications. Patellar height was also measured by applying the Caton–Deschamps index.

Results

A total of 100 patients were selected, involving 149 symptomatic knees. A significant correlation between trochlear and patellar dysplasia types was found (0.82; p < 0.0001). Dejour types B and C of trochlear dysplasia were significantly more often associated with patellar dysplasia than Dejour type A (p = 0.033 and p = 0.019, respectively). Moreover, severe Wiberg 3 patellar dysplasia was significantly associated with type D Dejour trochlear dysplasia than with the sum of all other Dejour types taken together (p < 0.0001).

Conclusion

This study confirms a linear correlation between the severity of patellar and trochlear dysplasia. Further studies are needed to evaluate the place of patellar dysplasia in the therapeutic strategy.

Level of evidence

Level IV.

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Authors and Affiliations

  1. Department of Orthopedic and Trauma Surgery, Centre Hospitalier de Versailles, André Mignot Hospital, Île-de-France Ouest University, 177 Rue de Versailles, 78150, Le Chesnay, France

    Victor Meissburger, Grégoire Rougereau, Philippe Boisrenoult & Nicolas Pujol

  2. Department of Pediatric Orthopedics, Hôpital des enfants, Toulouse University, Purpan, 31059, Toulouse, France

    Tristan Langlais

  3. Department of Pediatric Orthopedics, Hôpital Armand-Trousseau, AP-HP, Sorbonne University, 26 avenue du Dr-Arnold-Netter, 75012, Paris, France

    Tristan Langlais

Authors
  1. Victor Meissburger
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  2. Grégoire Rougereau
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  3. Tristan Langlais
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  4. Philippe Boisrenoult
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  5. Nicolas Pujol
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Contributions

VM and GR participated in the data measurements, and article writing. NP and DD participated in the study design and manuscript revision. TL participated in data interpretation and statistical analysis. Each author has given final approval of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Nicolas Pujol.

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Meissburger, V., Rougereau, G., Langlais, T. et al. The severity of patellar and trochlear dysplasia are correlated. Knee Surg Sports Traumatol Arthrosc (2022). https://doi.org/10.1007/s00167-022-06945-0

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Keywords

  • Patellar dislocation
  • Patellar dysplasia
  • Trochlear dysplasia
  • Trochleoplasty
  • Patellar instability
  • Knee