Service de chirurgie orthopédique et médecine du sport, Hôpital de la Croix-Rousse, Centre hospitalier universitaire de Lyon, Hospices civils de Lyon, 103, grande rue de la Croix Rousse, 69004 Lyon, France.
Service de chirurgie orthopédique et médecine du sport, Hôpital de la Croix-Rousse, Centre hospitalier universitaire de Lyon, Hospices civils de Lyon, 103, grande rue de la Croix Rousse, 69004 Lyon, France.
Orthop Traumatol Surg Res. 2021 Nov;107(7):102895. doi: 10.1016/j.otsr.2021.102895. Epub 2021 Mar 19.
Patellofemoral osteoarthritis (PFOA) is usually associated with femorotibial osteoarthritis; isolated forms involve several specific risk factors. Trochlear dysplasia (TD) alters stress patterns in the patellofemoral joint, inducing PFOA. The association of TD and isolated PFOA was analyzed without distinguishing medial facet, global and lateral facet involvement. The study hypothesis was that TD prevalence is high in isolated lateral PFOA (ILPFOA). The aim of the study was to assess TD prevalence in a symptomatic ILPFOA population and identify risk factors.
Eighty-four patients (101 knees) underwent lateral vertical patellectomy (LVP) for symptomatic ILPFOA between November 1998 and September 2019. Demographic, clinical and radiographic data were collected retrospectively from preoperative records. TD was analyzed by 2 blinded surgeons on lateral radiographs.
TD prevalence was 88.1%. TD was significantly more advanced in patients under 45 years of age at surgery (64.5% stage 2 or 3; p=0.019). Non-TD cases showed significantly more frequent valgus deformity (83.3%; p=0.042) and overweight (BMI, 32±4.1; p<0.001).
TD is a known risk factor for PFOA, present in almost 9 in 10 cases in the present series of ILPFOA. These findings reinforce the hypothesis that it plays a role in onset of ILPFOA. TD also induces early pain, leading to surgery. Overweight and valgus deformity are contributing factors for ILPFOA.
IV; transverse study.
髌股关节骨关节炎（PFOA）通常与股胫关节骨关节炎相关；孤立型 PFOA 涉及多个特定的危险因素。滑车发育不良（TD）改变髌股关节的应力模式，从而导致 PFOA。本研究旨在分析 TD 与孤立性 PFOA（ILPFOA）的相关性，而不区分内侧、全侧和外侧关节面受累。研究假设是 TD 在孤立性外侧 PFOA（ILPFOA）中发病率较高。该研究的目的是评估症状性 ILPFOA 人群中 TD 的患病率，并确定危险因素。
1998 年 11 月至 2019 年 9 月，84 例（101 膝）因症状性 ILPFOA 行外侧垂直髌骨切除术（LVP）。回顾性收集术前记录的人口统计学、临床和影像学资料。由 2 位盲法外科医生对侧位 X 线片进行 TD 分析。
TD 患病率为 88.1%。手术时年龄小于 45 岁的患者 TD 更严重（64.5%为 2 期或 3 期；p=0.019）。非 TD 病例的外翻畸形更为常见（83.3%；p=0.042），体重指数（BMI）也较高（32±4.1；p<0.001）。
TD 是 PFOA 的已知危险因素，在本系列 ILPFOA 中，近 9 成的病例存在 TD。这些发现进一步证实了 TD 在 ILPFOA 发病中的作用。TD 还会引起早期疼痛，导致手术。超重和外翻畸形是 ILPFOA 的促成因素。
IV；横断研究。
