Department of Orthopedic and Trauma Surgery, Centre Hospitalier de Versailles, André Mignot Hospital, Île-de-France Ouest University, 177 Rue de Versailles, 78150, Le Chesnay, France.
Department of Pediatric Orthopedics, Hôpital des enfants, Toulouse University, Purpan, 31059, Toulouse, France.
Knee Surg Sports Traumatol Arthrosc. 2022 Oct;30(10):3438-3443. doi: 10.1007/s00167-022-06945-0. Epub 2022 Mar 26.
Patellar instability is a frequent clinical situation in adolescents and young adults. One of the most important risk factors of this condition is trochlea dysplasia. Few studies have analyzed the role of patellar dysplasia. The objective of this paper was to assess the correlation between trochlear and patellar dysplasia. The hypothesis is that patellar dysplasia increased in parallel with femoral trochlear dysplasia.
The study included patients operated on at least one knee for patellar instability between 2008 and 2020. For these patients, symptomatic knees (operated or not) were included if they had lateral and patellofemoral skyline radiographs. Two blinded observers categorized each trochlear and patellar dysplasia according to the Dejour and Wiberg classifications. Patellar height was also measured by applying the Caton-Deschamps index.
A total of 100 patients were selected, involving 149 symptomatic knees. A significant correlation between trochlear and patellar dysplasia types was found (0.82; p < 0.0001). Dejour types B and C of trochlear dysplasia were significantly more often associated with patellar dysplasia than Dejour type A (p = 0.033 and p = 0.019, respectively). Moreover, severe Wiberg 3 patellar dysplasia was significantly associated with type D Dejour trochlear dysplasia than with the sum of all other Dejour types taken together (p < 0.0001).
This study confirms a linear correlation between the severity of patellar and trochlear dysplasia. Further studies are needed to evaluate the place of patellar dysplasia in the therapeutic strategy.
Level IV.
髌骨不稳定是青少年和年轻成年人常见的临床情况。这种情况的最重要危险因素之一是滑车发育不良。很少有研究分析过髌骨发育不良的作用。本文的目的是评估滑车和髌骨发育不良之间的相关性。假设是髌骨发育不良与股骨滑车发育不良平行增加。
该研究纳入了 2008 年至 2020 年间至少一侧膝关节因髌骨不稳定而接受手术的患者。对于这些患者，如果外侧和髌股侧位线片存在症状性膝关节（手术或未手术），则将其纳入研究。两名盲法观察者根据 Dejour 和 Wiberg 分类对每个滑车和髌骨发育不良进行分类。还通过应用 Caton-Deschamps 指数测量髌骨高度。
共选择了 100 名患者，涉及 149 个症状性膝关节。发现滑车和髌骨发育不良类型之间存在显著相关性（0.82；p<0.0001）。滑车发育不良的 Dejour 类型 B 和 C 与髌骨发育不良显著相关，而 Dejour 类型 A 则不然（p=0.033 和 p=0.019）。此外，严重的 Wiberg 3 型髌骨发育不良与 Dejour 类型 D 滑车发育不良显著相关，而与其他所有 Dejour 类型的总和相比（p<0.0001）。
本研究证实了髌骨和滑车发育不良严重程度之间存在线性相关性。需要进一步研究来评估髌骨发育不良在治疗策略中的地位。
IV 级。
