van Huyssteen A L, Hendrix M R G, Barnett A J, Wakeley C J, Eldridge J D J
Department of Orthopaedic Surgery, Claremont Hospital, Main Road, Claremont 7708, South Africa.
J Bone Joint Surg Br. 2006 May;88(5):688-91. doi: 10.1302/0301-620X.88B5.16866.
Trochlear dysplasia is an important anatomical abnormality in symptomatic patellar instability. Our study assessed the mismatch between the bony and cartilaginous morphology in patients with a dysplastic trochlea compared with a control group. MRI scans of 25 knees in 23 patients with trochlear dysplasia and in 11 patients in a randomly selected control group were reviewed retrospectively in order to assess the morphology of the cartilaginous and bony trochlea. Inter- and intra-observer error was assessed. In the dysplastic group there were 15 women and eight men with a mean age of 20.4 years (14 to 30). The mean bony sulcus angle was 167.9 degrees (141 degrees to 203 degrees), whereas the mean cartilaginous sulcus angle was 186.5 degrees (152 degrees to 214 degrees; p < 0.001). In 74 of 75 axial images (98.7%) the cartilaginous contour was different from the osseous contour on subjective assessment, the cartilage exacerbated the abnormality. Our study shows that the morphology of the cartilaginous trochlea differs markedly from that of the underlying bony trochlea in patients with trochlear dysplasia. MRI is necessary in order to demonstrate the pathology and to facilitate surgical planning.
滑车发育不良是有症状的髌骨不稳定的一种重要解剖学异常。我们的研究评估了发育不良滑车患者与对照组相比，其骨质和软骨形态之间的不匹配情况。对23例患有滑车发育不良患者的25个膝关节以及随机选择的对照组中11例患者的MRI扫描进行回顾性分析，以评估软骨和骨质滑车的形态。评估了观察者间和观察者内误差。发育不良组有15名女性和8名男性，平均年龄20.4岁（14至30岁）。平均骨质沟角为167.9度（141度至203度），而平均软骨沟角为186.5度（152度至214度；p<0.001）。在75个轴向图像中的74个（98.7%）上，主观评估显示软骨轮廓与骨质轮廓不同，软骨加剧了异常情况。我们的研究表明，滑车发育不良患者的软骨滑车形态与下方骨质滑车的形态明显不同。MRI对于显示病变情况以及辅助手术规划是必要的。
