The role of the most cranial trochlear orientation in patellar maltracking to better characterise trochlear morphology.

Autor:	Giovannetti de Sanctis E; IULS-Institut Universitaire Locomoteur et Sports, Pasteur 2 Hospital, CHU, Nice, France.; Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Ramsay Santé, Lyon, France., Toanen C; Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Ramsay Santé, Lyon, France.; Service de Chirurgie Orthopédique, Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France., Guarino A; Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Ramsay Santé, Lyon, France.; Department of Public Health, Section of Orthopaedics, Federico II University, Naples, Italy., Pineda T; Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Ramsay Santé, Lyon, France.; Department of Orthopedic Surgery, Hospital El Carmen, Santiago, Chile., Deroche E; Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Ramsay Santé, Lyon, France.; Orthopaedic Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France., Dejour DH; Lyon-Ortho-Clinic: Clinique de la Sauvegarde, Ramsay Santé, Lyon, France.
Jazyk:	angličtina
Zdroj:	Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Nov; Vol. 32 (11), pp. 2909-2918. Date of Electronic Publication: 2024 Jun 23.
DOI:	10.1002/ksa.12314
Abstrakt:	Purpose: The purpose of our study is to describe a magnetic resonance imaging quantitative parameter to assess the morphology of the trochlea that could be measurable from normal to high-grade trochlear dysplasia while evaluating the most proximal slice with trochlear cartilage. Methods: Two groups of patients have been compared: patients with no patellofemoral pain, no previous trauma and undergoing surgery for a suspected isolated meniscal tears (group A) and patients with objective patellar instability (group B). The cranial trochlear orientation (CTO) angle is defined as the angle between the posterior bicondylar line and the most lateral and most medial points on the subchondral bone covered by cartilage digitised on the first and most cranial image with the trochlear cartilage clearly visible. Results: The final cohort included 253 patients (109 in group A and 144 in group B). CTO was significantly higher in group B (-2.5 ± 8.4 vs. -10.8 ± 5,1; p < .001). Moreover, 75% of knees in group B had a CTO > -7°, while 75% of knees in group A had a CTO < -7°. CTO was measurable in all 253 knees, whereas the lateral trochlear inclination and the sulcus angle were measurable in only 202 knees. The entire cohort was also divided into knees with CTO ≤ 0° and CTO > 0°. All knees with a CTO > 0 were in group B, and 49% of knees with CTO < 0 were in group B. CTO was positively correlated with lateral patellar tilt. Conclusions: CTO is the only parameter that can be measured on the most cranial slice, in every patient, even in high-grade trochlear dysplasia. According to this new system, the axial trochlear shape may be divided into two types: a positive CTO and a negative CTO, with the trochlea serving, respectively, as a medial and lateral barrier. Level of Evidence: Level III. (© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze:	MEDLINE
Externí odkaz:	Plný text