Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2018

01-03-2018 | Knee

Quality assessment of radiological measurements of trochlear dysplasia; a literature review

Authors: Mathias Paiva, Lars Blønd, Per Hölmich, Robert N. Steensen, Gerd Diederichs, Julian A. Feller, Kristoffer Weisskirchner Barfod

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2018

Login to get access

Abstract

Purpose

To make a systematic review with quality assessments of the known measurements used to describe trochlear dysplasia.

Methods

A systematic literature search was conducted in the databases PubMed and Embase using the search string “trochlea dysplasia OR trochlear dysplasia”. Papers were screened for their relevance based on predefined parameters, and all measurements showing a statistical association between trochlear dysplasia and patellar instability were presented. Four experts evaluated the quality of the measures using a purpose-made quality scale.

Results

The search generated 600 papers of which eight were chosen for review. Thirty-three unique measurements were identified and described in order of their date of publication. The lateral trochlea inclination was rated highest by the expert panel. The crossing sign, the trochlea bump, the TT–TG distance, the trochlea depth and the ventral trochlea prominence also had high ratings.

Conclusion

Thirty-three unique measurements were identified with the lateral trochlea inclination as the highest rated measurement by the expert panel, and it is recommended for use in assessment of trochlear dysplasia. The crossing sign, the trochlea bump, the TT–TG, the trochlea depth and the ventral trochlea prominence were also rated well and can be recommended for use.

Level of evidence

V.
Appendix
Available only for authorised users
Literature
1.
go back to reference Balcarek P, Rehn S, Howells NR, Eldridge JD, Kita K, Dejour D, Nelitz M, Banke IJ, Lambrecht D, Harden M, Friede T (2016) Results of medial patellofemoral ligament reconstruction compared with trochleoplasty plus individual extensor apparatus balancing in patellar instability caused by severe trochlear dysplasia: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-016-4365-x PubMed Balcarek P, Rehn S, Howells NR, Eldridge JD, Kita K, Dejour D, Nelitz M, Banke IJ, Lambrecht D, Harden M, Friede T (2016) Results of medial patellofemoral ligament reconstruction compared with trochleoplasty plus individual extensor apparatus balancing in patellar instability caused by severe trochlear dysplasia: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-016-4365-x PubMed
2.
go back to reference Biedert RM, Albrecht S (2006) The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 14(8):707–712CrossRefPubMed Biedert RM, Albrecht S (2006) The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 14(8):707–712CrossRefPubMed
3.
go back to reference Biedert RM, Netzer P, Gal I, Sigg A, Tscholl PM (2011) The lateral condyle index: a new index for assessing the length of the lateral articular trochlea as predisposing factor for patellar instability. Int Orthop 35(9):1327–1331CrossRefPubMed Biedert RM, Netzer P, Gal I, Sigg A, Tscholl PM (2011) The lateral condyle index: a new index for assessing the length of the lateral articular trochlea as predisposing factor for patellar instability. Int Orthop 35(9):1327–1331CrossRefPubMed
4.
go back to reference 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):1225–1230CrossRefPubMed 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):1225–1230CrossRefPubMed
5.
go back to reference Botchu R, Obaid H, Rennie WJ (2013) Correlation between trochlear dysplasia and the notch index. J Orthop Surg (Hong Kong) 21(3):290–293CrossRef Botchu R, Obaid H, Rennie WJ (2013) Correlation between trochlear dysplasia and the notch index. J Orthop Surg (Hong Kong) 21(3):290–293CrossRef
6.
go back to reference Carrillon Y, Abidi H, Dejour D, Fantino O, Moyen B, Tran-Minh VA (2000) Patellar instability: assessment on MR images by measuring the lateral trochlear inclination—initial experience. Radiology 216(2):582–585CrossRefPubMed Carrillon Y, Abidi H, Dejour D, Fantino O, Moyen B, Tran-Minh VA (2000) Patellar instability: assessment on MR images by measuring the lateral trochlear inclination—initial experience. Radiology 216(2):582–585CrossRefPubMed
7.
go back to reference Dejour H, Walch G, Neyret P, Adeleine P (1990) Dysplasia of the femoral trochlea. Rev Chir Orthop Reparatrice Appar Mot 76(1):45–54PubMed Dejour H, Walch G, Neyret P, Adeleine P (1990) Dysplasia of the femoral trochlea. Rev Chir Orthop Reparatrice Appar Mot 76(1):45–54PubMed
8.
go back to reference 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):19–26CrossRefPubMed 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):19–26CrossRefPubMed
9.
go back to reference Diederichs G, Issever AS, Scheffler S (2010) MR imaging of patellar instability: injury patterns and assessment of risk factors. Radiographics 30(4):961–981CrossRefPubMed Diederichs G, Issever AS, Scheffler S (2010) MR imaging of patellar instability: injury patterns and assessment of risk factors. Radiographics 30(4):961–981CrossRefPubMed
10.
go back to reference Fucentese SF, von Roll A, Koch PP, Epari DR, Fuchs B, Schottle PB (2006) The patella morphology in trochlear dysplasia—a comparative MRI study. Knee 13(2):145–150CrossRefPubMed Fucentese SF, von Roll A, Koch PP, Epari DR, Fuchs B, Schottle PB (2006) The patella morphology in trochlear dysplasia—a comparative MRI study. Knee 13(2):145–150CrossRefPubMed
11.
go back to reference Fulkerson JP (2002) Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 30(3):447–456CrossRefPubMed Fulkerson JP (2002) Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 30(3):447–456CrossRefPubMed
12.
go back to reference Hawkins RJ, Bell RH, Anisette G (1986) Acute patellar dislocations: the natural history. Am J Sports Med 14(2):117–120CrossRefPubMed Hawkins RJ, Bell RH, Anisette G (1986) Acute patellar dislocations: the natural history. Am J Sports Med 14(2):117–120CrossRefPubMed
13.
go back to reference Keser S, Savranlar A, Bayar A, Ege A, Turhan E (2008) Is there a relationship between anterior knee pain and femoral trochlear dysplasia? Assessment of lateral trochlear inclination by magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 16(10):911–915CrossRefPubMed Keser S, Savranlar A, Bayar A, Ege A, Turhan E (2008) Is there a relationship between anterior knee pain and femoral trochlear dysplasia? Assessment of lateral trochlear inclination by magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 16(10):911–915CrossRefPubMed
14.
go back to reference Köhlitz T, Scheffler S, Jung T, Hoburg A, Vollnberg B, Wiener E, Diederichs G (2013) Prevalence and patterns of anatomical risk factors in patients after patellar dislocation: a case control study using MRI. Eur Radiol 23(4):1067–1074CrossRefPubMed Köhlitz T, Scheffler S, Jung T, Hoburg A, Vollnberg B, Wiener E, Diederichs G (2013) Prevalence and patterns of anatomical risk factors in patients after patellar dislocation: a case control study using MRI. Eur Radiol 23(4):1067–1074CrossRefPubMed
15.
go back to reference Lippacher S, Reichel H, Nelitz M (2011) Radiological criteria for trochlear dysplasia in children and adolescents. J Pediatr Orthop B 20(5):341–344CrossRefPubMed Lippacher S, Reichel H, Nelitz M (2011) Radiological criteria for trochlear dysplasia in children and adolescents. J Pediatr Orthop B 20(5):341–344CrossRefPubMed
16.
go back to reference Mehl J, Feucht MJ, Bode G, Dovi-Akue D, Südkamp NP, Niemeyer P (2016) Association between patellar cartilage defects and patellofemoral geometry: a matched-pair MRI comparison of patients with and without isolated patellar cartilage defects. Knee Surg Sports Traumatol Arthrosc 24(3):838–846CrossRefPubMed Mehl J, Feucht MJ, Bode G, Dovi-Akue D, Südkamp NP, Niemeyer P (2016) Association between patellar cartilage defects and patellofemoral geometry: a matched-pair MRI comparison of patients with and without isolated patellar cartilage defects. Knee Surg Sports Traumatol Arthrosc 24(3):838–846CrossRefPubMed
17.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341CrossRefPubMed Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341CrossRefPubMed
18.
go back to reference Nelitz M, Lippacher S, Reichel H, Dornacher D (2014) Evaluation of trochlear dysplasia using MRI: correlation between the classification system of Dejour and objective parameters of trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 22(1):120–127CrossRefPubMed Nelitz M, Lippacher S, Reichel H, Dornacher D (2014) Evaluation of trochlear dysplasia using MRI: correlation between the classification system of Dejour and objective parameters of trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 22(1):120–127CrossRefPubMed
19.
go back to reference Ntagiopoulos PG, Bonin N, Sonnery-Cottet B, Badet R, Dejour D (2014) The incidence of trochlear dysplasia in anterior cruciate ligament tears. Int Orthop 38(6):1269–1275CrossRefPubMedPubMedCentral Ntagiopoulos PG, Bonin N, Sonnery-Cottet B, Badet R, Dejour D (2014) The incidence of trochlear dysplasia in anterior cruciate ligament tears. Int Orthop 38(6):1269–1275CrossRefPubMedPubMedCentral
20.
go back to reference Pfirrmann CW, Zanetti M, Romero J, Hodler J (2000) Femoral trochlear dysplasia: MR findings. Radiology 216(3):858–864CrossRefPubMed Pfirrmann CW, Zanetti M, Romero J, Hodler J (2000) Femoral trochlear dysplasia: MR findings. Radiology 216(3):858–864CrossRefPubMed
21.
go back to reference Remy F, Besson A, Migaud H, Cotten A, Gougeon F, Duquennoy A (1998) Reproducibility of the radiographic analysis of dysplasia of the femoral trochlea. Intra- and Interobserver analysis of 68 knees. Rev Chir Orthop Reparatrice Appar Mot 84(8):728–733PubMed Remy F, Besson A, Migaud H, Cotten A, Gougeon F, Duquennoy A (1998) Reproducibility of the radiographic analysis of dysplasia of the femoral trochlea. Intra- and Interobserver analysis of 68 knees. Rev Chir Orthop Reparatrice Appar Mot 84(8):728–733PubMed
22.
go back to reference Sillanpää P, Mattila VM, Iivonen T, Visuri T, Pihlajamäki H (2008) Incidence and risk factors of acute traumatic primary patellar dislocation. Med Sci Sports Exerc 40(4):606–611CrossRefPubMed Sillanpää P, Mattila VM, Iivonen T, Visuri T, Pihlajamäki H (2008) Incidence and risk factors of acute traumatic primary patellar dislocation. Med Sci Sports Exerc 40(4):606–611CrossRefPubMed
23.
go back to reference 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):873–878CrossRefPubMed 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):873–878CrossRefPubMed
24.
go back to reference Steensen RN, Bentley JC, Trinh TQ, Backes JR, Wiltfong RE (2015) The prevalence and combined prevalences of anatomic factors associated with recurrent patellar dislocation: a magnetic resonance imaging study. Am J Sports Med 43(4):921–927CrossRefPubMed Steensen RN, Bentley JC, Trinh TQ, Backes JR, Wiltfong RE (2015) The prevalence and combined prevalences of anatomic factors associated with recurrent patellar dislocation: a magnetic resonance imaging study. Am J Sports Med 43(4):921–927CrossRefPubMed
25.
go back to reference Van Haver A, De Roo K, De Beule M, Van Cauter S, Audenaert E, Claessens T, Verdonk P (2014) Semi-automated landmark-based 3D analysis reveals new morphometric characteristics in the trochlear dysplastic femur. Knee Surg Sports Traumatol Arthrosc 22(11):2698–2708CrossRefPubMed Van Haver A, De Roo K, De Beule M, Van Cauter S, Audenaert E, Claessens T, Verdonk P (2014) Semi-automated landmark-based 3D analysis reveals new morphometric characteristics in the trochlear dysplastic femur. Knee Surg Sports Traumatol Arthrosc 22(11):2698–2708CrossRefPubMed
26.
go back to reference Vollnberg B, Koehlitz T, Jung T, Scheffler S, Hoburg A, Khandker D, Hamm B, Wiener E, Diederichs G (2012) Prevalence of cartilage lesions and early osteoarthritis in patients with patellar dislocation. Eur Radiol 22(11):2347–2356CrossRefPubMed Vollnberg B, Koehlitz T, Jung T, Scheffler S, Hoburg A, Khandker D, Hamm B, Wiener E, Diederichs G (2012) Prevalence of cartilage lesions and early osteoarthritis in patients with patellar dislocation. Eur Radiol 22(11):2347–2356CrossRefPubMed
Metadata
Title
Quality assessment of radiological measurements of trochlear dysplasia; a literature review
Authors
Mathias Paiva
Lars Blønd
Per Hölmich
Robert N. Steensen
Gerd Diederichs
Julian A. Feller
Kristoffer Weisskirchner Barfod
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4520-z

Other articles of this Issue 3/2018

Knee Surgery, Sports Traumatology, Arthroscopy 3/2018 Go to the issue