Skip to main content

Advertisement

Log in

Trochlear dysplasia relates to medial femoral condyle hypoplasia: an MRI-based study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Trochlear dysplasia is one of the most important pathomorphologies predisposing to patellofemoral instability. The development of the trochlea groove is not well understood so far. We hypothesized that the underlying pathology of trochlear dysplasia is a medial hypoplasia.

Methods

110 magnetic resonance imaging (MRI) scans from adult knees, 55 with and 55 without trochlear dysplasia were analyzed. On the axial and sagittal T2 MRI sequences, the height (h), width (w) and depth (d) of the medial (MC) and lateral femoral condyle (LC) as well as the depth of the trochlea groove (dTG) were measured using a three-dimensional measuring algorithm.

Results

For all calculated values of the lateral femoral condyle, the comparison of both groups showed no significant difference (p = 0.95, p = 0.11, p = 0.07). The depth of the trochlear groove (dTG) showed significant lower values in the study group (p < 0.05). In the study group, all measurements of the medial femoral condyle were statistically significantly smaller compared to the control group (p < 0.05).

Conclusions

We found that the height, the width and the depth of the medial condyle is significant smaller in patients with trochlea dysplasia than in healthy controls. The measurements of the lateral femoral condyle showed no significant difference. Patients with a dysplastic trochlea have a hypoplastic medial femoral condyle and a more medially placed trochlea groove compared to controls.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Biedert RM, Bachmann M (2009) Anterior-posterior trochlear measurements of normal and dysplastic trochlea by axial magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 17(10):1225–1230

    Article  Google Scholar 

  2. Dejour D, Le Coultre B (2007) Osteotomies in patello-femoral instabilities. Sports Med Arthrosc 15(1):39–46

    Article  Google Scholar 

  3. Dejour H, Walch G, Neyret P, Adeleine P (1990) Dysplasia of the femoral trochlea. Rev Chir Orthop Reparatrice Appar Mot 76(1):45–54

    CAS  PubMed  Google Scholar 

  4. Dejour H, Walch G, Nove-Josserand L, Guier C (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 2(1):19–26

    Article  CAS  Google Scholar 

  5. Doskocil M (1985) Formation of the femoropatellar part of the human knee joint. Folia Morphol (Praha) 33(1):38–47

    CAS  Google Scholar 

  6. Dupont JY (1995) Patellar subluxation: where are we in 1995? Acta Orthop Belg 61(3):155–168

    CAS  PubMed  Google Scholar 

  7. Garron E, Jouve JL, Tardieu C, Panuel M, Dutour O, Bollini G (2003) Anatomic study of the anterior patellar groove in the fetal period. Rev Chir Orthop Reparatrice Appar Mot 89(5):407–412

    CAS  PubMed  Google Scholar 

  8. Hohlweck J, Quack V, Arbab D, Spreckelsen C, Tingart M, Lüring C, Rath B (2013) Diagnostic and therapeutic management of primary and recurrent patellar dislocations-analysis of a nationwide survey and the current literature. Z Orthop Unfall 151(4):380–388

    Article  CAS  Google Scholar 

  9. Kohlhof H, Heidt C, Bahler A et al (2015) Can 3D ultrasound identify trochlea dysplasia in newborns? Evaluation and applicability of a technique. Eur J Radiol 84(6):1159–1164

    Article  Google Scholar 

  10. Miller GF (1978) Familial recurrent dislocation of the patella. J Bone Joint Surg Br 60(2):203–204

    Article  Google Scholar 

  11. Nietosvaara Y, Aalto K (1997) The cartilaginous femoral sulcus in children with patellar dislocation: an ultrasonographic study. J Pediatr Orthop 17(1):50–53

    CAS  PubMed  Google Scholar 

  12. Oye CR, Holen KJ, Foss OA (2015) Mapping of the femoral trochlea in a newborn population: an ultrasonographic study. Acta Radio 56(2):234–243

    Article  Google Scholar 

  13. Salzmann GM, Weber TS, Spang JT, Imhoff AB, Schottle PB (2010) Comparison of native axial radiographs with axial MR imaging for determination of the trochlear morphology in patients with trochlear dysplasia. Arch Orthop Trauma Surg 130(3):335–340

    Article  Google Scholar 

  14. Skelley N, Friedman M, McGinnis M, Smith C, Hillen T, Matava M (2015) Inter- and intraobserver reliability in the MRI measurement of the tibial tubercle-trochlear groove distance and trochlea dysplasia. Am J Sports Med 43(4):873–878

    Article  Google Scholar 

  15. Staubli HU, Durrenmatt U, Porcellini B, Rauschning W (1999) Anatomy and surface geometry of the patellofemoral joint in the axial plane. J Bone Joint Surg Br 81(3):452–458

    Article  CAS  Google Scholar 

  16. Stepanovich M, Bomar JD, Pennock AT (2016) Are the current classifications and radiographic measurements for trochlear dysplasia appropriate in the skeletally immature patient? Orthop J Sports Med 4(10):2325967116669490

    Article  Google Scholar 

  17. Tardieu C, Dupont JY (2001) The origin of femoral trochlear dysplasia: comparative anatomy, evolution, and growth of the patellofemoral joint. Rev Chir Orthop Reparatrice Appar Mot 87(4):373–383

    CAS  PubMed  Google Scholar 

  18. Walmsley R (1940) The development of the patella. J Anat 74(Pt 3):360–368

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Armin Keshmiri.

Ethics declarations

Conflict of interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The work was performed at the Knee and Hip Institute Munich.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Keshmiri, A., Schöttle, P. & Peter, C. Trochlear dysplasia relates to medial femoral condyle hypoplasia: an MRI-based study. Arch Orthop Trauma Surg 140, 155–160 (2020). https://doi.org/10.1007/s00402-019-03233-4

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-019-03233-4

Keywords

Navigation