Onor Gabriel I, Yalcin Sercan, Kaar Scott G, Pace J Lee, Ferrua Paolo, Farrow Lutul D
Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
Cleveland Clinic Orthopaedic and Rheumatologic Institute, Cleveland, Ohio, USA.
Orthop J Sports Med. 2021 Apr 2;9(4):2325967121994548. doi: 10.1177/2325967121994548. eCollection 2021 Apr.
The femoral trochlea is considered the most significant osseous factor affecting stability in the patellofemoral joint. The true prevalence of trochlear dysplasia in the general population is largely unknown.
PURPOSE/HYPOTHESIS: To investigate the prevalence of trochlear dysplasia in the general population. Our hypothesis was that, while trochlear dysplasia is not uncommon, there is a low prevalence of severe dysplasia in the general population.
Descriptive epidemiology study.
Five observers were asked to evaluate 692 skeletally mature femoral specimens from 359 skeletons for trochlear dysplasia at 2 time points. We further subclassified the dysplastic trochlea in 62 femora with the highest rated degree of dysplasia.
Sex ( = .11) and race ( = .2) had no effect on the severity of dysplasia. Interobserver reliability was excellent (0.906 and 0.904), and intraobserver reliability was good to excellent (0.686 to 0.808). The percentages of trochlea graded as normal, mildly dysplastic, moderately dysplastic, and severely dysplastic were 61.5%, 21.4%, 12.7%, and 4.4%, respectively, in the first evaluation, and 58.5%, 23.7%, 12.7%, and 5.1% in the second evaluation. Of the 62 trochlea with the highest scores for dysplasia, 36 had trochlear dysplasia without a supratrochlear spur, 8 had trochlear dysplasia with medial femoral condyle hypoplasia, and 18 had trochlear dysplasia with a supratrochlear spur.
Observers with differing degrees of clinical experience had similar opinions on the degree of trochlear dysplasia. Also, our cohort showed that moderate to severe dysplasia is not uncommon, as it is present in approximately 17% of knees in our cohort. Our findings also suggest that clinicians are speaking the same language when identifying and describing trochlear dysplasia on gross inspection.
股骨滑车被认为是影响髌股关节稳定性的最重要骨因素。一般人群中滑车发育异常的真实患病率很大程度上未知。
目的/假设：调查一般人群中滑车发育异常的患病率。我们的假设是，虽然滑车发育异常并不罕见，但一般人群中严重发育异常的患病率较低。
描述性流行病学研究。
要求5名观察者在2个时间点评估来自359具骨骼的692个骨骼成熟的股骨标本的滑车发育异常情况。我们进一步对62个股骨中发育异常程度评分最高的发育异常滑车进行了亚分类。
性别（P = 0.11）和种族（P = 0.2）对发育异常的严重程度没有影响。观察者间可靠性极佳（0.906和0.904），观察者内可靠性良好至极佳（0.686至0.808）。在第一次评估中，滑车分级为正常、轻度发育异常、中度发育异常和重度发育异常的百分比分别为61.5%、21.4%、12.7%和4.4%，在第二次评估中分别为58.5%、23.7%、12.7%和5.1%。在62个发育异常评分最高的滑车中，36个有滑车发育异常但无滑车嵴，8个有滑车发育异常合并股骨内侧髁发育不全，18个有滑车发育异常合并滑车嵴。
具有不同临床经验程度的观察者对滑车发育异常程度的看法相似。此外，我们的队列显示中度至重度发育异常并不罕见，在我们的队列中约17%的膝关节存在这种情况。我们的研究结果还表明，临床医生在大体检查中识别和描述滑车发育异常时使用的是同一标准。
