Tan Si Heng Sharon, Chng Kiat Soon Jason, Lim Beatrice Ying, Wong Keng Lin, Doshi Chintan, Lim Andrew Kean Seng, Hui James Hoipo
Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore.
J Knee Surg. 2020 Mar;33(3):235-241. doi: 10.1055/s-0038-1677541. Epub 2019 Jan 24.
The cartilaginous sulcus angle and bony sulcus angle have been widely used to evaluate trochlea dysplasia. The current review aims to evaluate (1) whether there is a difference in measurement for cartilaginous and bony sulcus angles, (2) whether both the cartilaginous and bony sulcus angles could be used to differentiate between patients with or without trochlear dysplasia, and (3) whether the same cut-off of 145 degrees, originally used for radiographs, can be applied for the cartilaginous and bony sulcus angles measured on CT and MRI. The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRSIMA) guidelines. A total of 11 publications with 1204 patients were included. All publications reported the sulcus angle to be greater in patients with patellofemoral instability. All publications reported the cartilaginous sulcus angle to be greater than the bony sulcus angle (MD 7.27 degrees; 95% CI: 5.67 - 8.87). The mean cartilaginous sulcus angle for the control group was 141.83 degrees (95% CI: 139.90 - 143.76) while the mean cartilaginous sulcus angle for patients with patellofemoral instability was 156.24 degrees (95% CI: 153.71 - 158.77). The mean bony sulcus angle for the control group was noted to be 133.69 degrees (95% CI: 131.23 - 136.15) while the mean bony sulcus angle for patients with patellofemoral instability was 148.42 (95% CI: 144.02 - 152.82). Both the cartilaginous and bony sulcus angles measured on CT and MRI could therefore be used to differentiate between patients with and without trochlear dysplasia. However, the cartilaginous sulcus angles are significantly higher than that of bony sulcus angles. Different cut off values should therefore be used.
软骨沟角和骨沟角已被广泛用于评估滑车发育不良。本综述旨在评估：（1）软骨沟角和骨沟角的测量是否存在差异；（2）软骨沟角和骨沟角是否均可用于区分有无滑车发育不良的患者；（3）最初用于X线片的145度这一相同临界值是否可应用于CT和MRI测量的软骨沟角和骨沟角。本综述按照系统评价和Meta分析的首选报告项目（PRSIMA）指南进行。共纳入11篇文献，涉及1204例患者。所有文献均报道髌股关节不稳定患者的沟角更大。所有文献均报道软骨沟角大于骨沟角（平均差值7.27度；95%置信区间：5.67 - 8.87）。对照组的平均软骨沟角为141.83度（95%置信区间：139.90 - 143.76），而髌股关节不稳定患者的平均软骨沟角为156.24度（95%置信区间：153.71 - 158.77）。对照组的平均骨沟角为133.69度（95%置信区间：131.23 - 136.15），而髌股关节不稳定患者的平均骨沟角为148.42度（95%置信区间：144.02 - 152.82）。因此，CT和MRI测量的软骨沟角和骨沟角均可用于区分有无滑车发育不良的患者。然而，软骨沟角显著高于骨沟角。因此应使用不同的临界值。
