Saccomanno Maristella F, Maggini Emanuele, Vaisitti Niccolò, Pianelli Antonio, Grava Giuseppe, Cattaneo Stefano, Milano Giuseppe
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy.
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Arthroscopy. 2023 Feb;39(2):549-568. doi: 10.1016/j.arthro.2022.08.039. Epub 2022 Oct 6.
To summarize data on the reliability of available imaging criteria for the assessment of trochlear dysplasia and to assess the methodological quality of the included studies.
This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline. Search was performed using major electronic databases from their inception to September 2021. All studies enrolling patients of any age who underwent a radiological exam to rule out features related to trochlear dysplasia were included. After the identification of available imaging criteria, reliability studies were analyzed. Descriptive statistics were used to summarize findings. Methodological quality was assessed using the Quality Appraisal of Reliability studies checklist.
A total of 2391 articles were identified, and 33 articles comprising 3036 patients with a mean age of 28.6 years were included. Thirty different measurements were extracted. Magnetic resonance imaging (MRI) was the most used imaging modalities (21 studies), followed by computed tomography (10 studies), conventional radiology (8 studies) and ultrasonography (US) (1 study). Sulcus angle, trochlear depth, and Dejour's classification were the most explored measurements. Overall, sulcus angle can be reliably assessed on radiography, CT and MRI, whereas trochlear depth can be reliably measured only with CT and MRI. Reliability of Dejour's classification ranged from poor or fair to very good for all imaging modalities. Methodological quality of included studies varied from 2 to 9 positive items out of 11 possible. Twenty-four studies (72.7%) were considered at high risk of bias.
Trochlear dysplasia can be reliably evaluated at least with 3 measurements: sulcus angle, trochlear depth and Dejour's classification. Methodological quality assessment showed high risk of bias in most included studies.
Level III, systematic review of Level II-III studies.
总结现有用于评估滑车发育不良的影像学标准的可靠性数据，并评估纳入研究的方法学质量。
本系统评价遵循PRISMA（系统评价和Meta分析的首选报告项目）指南进行。使用主要电子数据库从其创建至2021年9月进行检索。纳入所有纳入任何年龄患者且进行了放射学检查以排除与滑车发育不良相关特征的研究。在确定可用的影像学标准后，对可靠性研究进行分析。使用描述性统计来总结研究结果。使用可靠性研究质量评估清单评估方法学质量。
共识别出2391篇文章，纳入33篇文章，包括3036例患者，平均年龄28.6岁。提取了30种不同的测量方法。磁共振成像（MRI）是最常用的成像方式（21项研究），其次是计算机断层扫描（10项研究）、传统放射学（8项研究）和超声检查（US）（1项研究）。沟角、滑车深度和德茹尔分类是研究最多的测量方法。总体而言，沟角可通过X线摄影、CT和MRI可靠评估，而滑车深度仅可通过CT和MRI可靠测量。德茹尔分类在所有成像方式中的可靠性范围从差或一般到非常好。纳入研究的方法学质量在11项可能的项目中从2项到9项阳性项目不等。24项研究（72.7%）被认为存在高偏倚风险。
至少通过3种测量方法可可靠评估滑车发育不良：沟角、滑车深度和德茹尔分类。方法学质量评估显示，大多数纳入研究存在高偏倚风险。
III级，对II-III级研究的系统评价。
