Mazy David, Angelelli Lucia, Cance Nicolas, Giovannetti de Sanctis Edoardo, Dejour David H
Orthopedic Surgery Department, Lyon Ortho Clinic, Clinique de la Sauvegarde, Lyon, France.
ULS - Institut Universitaire Locomoteur et Sports. Chirurgie orthopédique., Pasteur 2 Hospital, CHU, Nice, France.
Knee Surg Sports Traumatol Arthrosc. 2025 Mar;33(3):926-934. doi: 10.1002/ksa.12418. Epub 2024 Aug 6.
The objective is to evaluate the orientation of the trochlear groove in patients with objective patellar instability (OPI) compared to a control group. The hypothesis is that the trochlear groove angle (TGA) is correlated with the severity of the trochlear dysplasia.
From 2019 to 2023, magnetic resonance imaging of 82 knees with OPI were compared with 82 control knees. TGA quantified the angle between the femoral anatomical axis and the trochlear groove. The intraclass correlation coefficient for TGA was evaluated. Central spur in the sagittal plane (CSSP) and cranial trochlear orientation (CTO) angle were also measured. TGA, CSSP and CTO were compared between the two groups. A TGA subgroup analysis separating the OPI group into low-grade (CSSP < 5 mm or negative CTO) and high-grade dysplasia (CSSP ≥ 5 mm or positive CTO) was also performed.
A significant difference (p < 0.001) was found between the TGA of the OPI group (mean [SD], 11.3 [3.7]°) and the control group (4.2 [2.5]°). TGA for patients with high-grade dysplasia (11.9 [3.8]°) was significantly higher than patients with low-grade dysplasia (9.6 [3.9]°).
Patients with OPI have a TGA of 11°, compared to the control group, which exhibits a TGA of 4°. The femoral mechanical axis can be considered an appropriate threshold for separating these two groups. Furthermore, TGA is correlated with the severity of dysplasia.
Case-control study.
Level III.
本研究旨在评估与对照组相比，客观髌骨不稳定（OPI）患者的滑车沟方向。研究假设为滑车沟角（TGA）与滑车发育不良的严重程度相关。
2019年至2023年期间，对82例OPI患者的膝关节进行磁共振成像，并与82例对照膝关节进行比较。TGA用于量化股骨解剖轴与滑车沟之间的角度。评估TGA的组内相关系数。还测量矢状面中央嵴（CSSP）和颅侧滑车方向（CTO）角。比较两组之间的TGA、CSSP和CTO。还对OPI组进行了TGA亚组分析，将其分为低度发育不良（CSSP＜5mm或CTO为阴性）和高度发育不良（CSSP≥5mm或CTO为阳性）。
OPI组的TGA（平均值[标准差]，11.3[3.7]°）与对照组（4.2[2.5]°）之间存在显著差异（p＜0.001）。高度发育不良患者的TGA（11.9[3.8]°）显著高于低度发育不良患者（9.6[3.9]°）。
与TGA为4°的对照组相比，OPI患者的TGA为11°。股骨机械轴可被视为区分这两组的合适阈值。此外，TGA与发育不良的严重程度相关。
病例对照研究。
三级。
