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Influence of medial and lateral imaging plane inclination on assessment of trochlear depth, sulcus angle, and facet asymmetry in the setting of trochlear anatomy: a cadaveric study

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Abstract

Purpose

(1) to assess the influence of medial or lateral imaging plane inclination on the measurement of sulcus angle, trochlear depth, and facet asymmetry on transverse cross-sectional images. (2) to assess the effect of measurement level (height) on these respective parameters.

Materials and methods

Twenty dry femurs (9 left, 11 right) were imaged with CT. A 3D dataset was obtained from which axial images were reconstructed in the ideal plane without inclination as well as with 8° of medial and lateral inclination. Sulcus angle, trochlear depth, and facet asymmetry were measured on the 3 image sets. In addition, the measurements were performed at 5 mm and 10 mm from the superior margin of the medial trochlear facet. Statistical analysis consisted of the Wilcoxon test and calculation of measurement variation.

Results

There were no statistically significant differences between the indicated measurements on the reference set compared to medial or lateral inclination. All measurements were significantly different depending on measurement height.

Conclusion

Medial or lateral inclination in the transverse imaging plane of 8° does not influence the values of typical parameters used for the assessment of trochlear dysplasia. The measurement height has a significant influence, and a consensus should be found as to which is the optimal measurement height.

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References

  1. Chen H, Zhao D, **e J, Duan Q, Zhang J, Wu Z, Jiang J (2017) The outcomes of the modified Fulkerson osteotomy procedure to treat habitual patellar dislocation associated with high-grade trochlear dysplasia. BMC Musculoskelet 18:73. https://doi.org/10.1186/s12891-017-1417-4

    Article  Google Scholar 

  2. DeJour D, Saggin, (2010) The sulcus deepening trochleoplasty—the Lyon’s procedure. Int Orthop 34:311–316. https://doi.org/10.1007/s00264-009-0933-8

    Article  Google Scholar 

  3. Dietrich T, Fucentese S, Pfirrmann C (2016) Imaging of individual anatomical risk factors for patellar instability. Semin Musculoskelet Radiol 20:65–73. https://doi.org/10.1055/s-0036-1579675

    Article  Google Scholar 

  4. Duthon VB (2015) Acute traumatic patellar dislocation. Orthop Traumatol-Sur 101:S59-67. https://doi.org/10.1016/j.otsr.2014.12.001

    Article  CAS  Google Scholar 

  5. Ferlic PW, Runer A, Dammerer D, Wansch J, Hackl W, Liebensteiner MC (2018) Patella height correlates with trochlear dysplasia a computed tomography image analysis. Arthrosc 34:1921–1928. https://doi.org/10.1016/j.arthro.2018.01.051

    Article  Google Scholar 

  6. Jamali AA, Meehan JP, Moroski NM, Anderson MJ, Lamba R, Parise C (2017) Do small changes in rotation affect measurements of lower extremity limb alignment? J Orthop Res 12:77. https://doi.org/10.1186/s13018-017-0571-6

    Article  Google Scholar 

  7. Koëter S, Bongers EMHF, de Rooij J, van Kampen A (2006) Minimal rotation aberrations cause radiographic misdiagnosis of trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 14:713–717. https://doi.org/10.1007/s00167-005-0031-4

    Article  Google Scholar 

  8. Kyung HS, Kim HJ (2015) Patellofemoral ligament reconstruction: a comprehensive review. Knee surg relat res 27:133–140. https://doi.org/10.5792/ksrr.2015.27.3.133

    Article  Google Scholar 

  9. Lippacher S, Dejour D, Elsharkawi M, Dornacher D, Ring C, Dreyhaupt J, Reichel H, Nelitz M (2012) Observer agreement on the dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images. Am J Sports Med 40:837–843. https://doi.org/10.1177/0363546511433028

    Article  Google Scholar 

  10. 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 22:120–127. https://doi.org/10.1007/s00167-012-2321-y

    Article  CAS  Google Scholar 

  11. Paiva M, Blønd L, Hölmich P, Steensen RN, Diederichs G, Feller JA, Barfod KW (2018) Quality assessment of radiological measurements of trochlear dysplasia; a literature review. Knee Surg Sports Traumatol Arthrosc 22:120–127. https://doi.org/10.1007/s00167-017-4520-z

    Article  Google Scholar 

  12. Parikh SN, Lykissas MG, Gkiatas I (2018) Predicting risk of recurrent patellar dislocation. Curr Rev Musculoskelet. https://doi.org/10.1007/s12178-018-9480-5

    Article  Google Scholar 

  13. 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 43:921–927. https://doi.org/10.1177/0363546514563904

    Article  Google Scholar 

  14. Voss A, Shin SR, Murakami AM, Cote MP, Achtnich A, Herbst E, Schepsis AA, Edgar C (2017) Objective quantification of trochlear dysplasia: assessment of the difference in morphology between control and chronic patellofemoral instability patients. Knee 24:1247–1255. https://doi.org/10.1016/j.knee.2017.05.024

    Article  Google Scholar 

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Authors and Affiliations

  1. Odisee University School, Brussels, Belgium

    Kristel Vranken & Sofie Germonpré

  2. Department of Radiology, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Seema Doring, Nico Buls & Michel De Maeseneer

  3. Department of Orthopaedic Surgery, UZ Brussel, Brussels, Belgium

    Johan Vanlauwe

  4. Department of Anatomy, VUB, Brussels, Belgium

    Steven Provyn

  5. Department of Anatomy, Vrije Universiteit Brussel, Brussels, Belgium

    Aron De Smet

Authors
  1. Kristel Vranken
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  2. Seema Doring
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  3. Nico Buls
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  4. Johan Vanlauwe
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  5. Sofie Germonpré
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  6. Steven Provyn
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  7. Aron De Smet
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  8. Michel De Maeseneer
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Contributions

KV data collection, first manuscript, literature, SD manuscript revision, NB statistics, manuscript revision, JV anatomical study, analysis, Sofie Germonpré: study design, SP anatomical study, manuscript revision, ADS anatomical research, MDM study design, data analysis, final manuscript.

Corresponding author

Correspondence to Michel De Maeseneer.

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Vranken, K., Doring, S., Buls, N. et al. Influence of medial and lateral imaging plane inclination on assessment of trochlear depth, sulcus angle, and facet asymmetry in the setting of trochlear anatomy: a cadaveric study. Surg Radiol Anat 45, 207–213 (2023). https://doi.org/10.1007/s00276-022-03069-5

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  • DOI: https://doi.org/10.1007/s00276-022-03069-5

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