Brenner Jason D, Henick Steven M, Mehraban Alvandi Leila, Gjonbalaj Edina, Lo Yungtai, Schulz Jacob, Fornari Eric D, Levy Benjamin J, Junior Mauricio Drummond
Albert Einstein College of Medicine The Bronx New York USA.
Department of Orthopaedic Surgery Montefiore Einstein The Bronx New York USA.
J Exp Orthop. 2025 Sep 5;12(3):e70425. doi: 10.1002/jeo2.70425. eCollection 2025 Jul.
The primary purpose was to assess sulcus angle (SA) magnetic resonance imaging (MRI) measurements and determine diagnostic cutoff values along four axial levels on cartilaginous and osseous surfaces comparing those with patellar dislocations (PD) versus controls. A secondary aim was to identify differences in SA between patients with one-time dislocation (OTD) versus recurrent patellar dislocations (RPDs).
Paediatric patients with a history of PD were retrospectively grouped into those with an OTD versus RPDs. Age and sex frequency matching controls (ACL injuries without PD history) were identified. The SA was recorded at four levels in the trochlear groove (TG) on cartilaginous and osseous surfaces. Differences between sample means (PDs vs. controls; RPDs vs. OTDs) were assessed; cutoff values for discriminating PDs from controls were identified utilising Youden's index.
There were 173 PDs (106 RPDs, 67 OTDs) and 100 controls. There were differences in mean SA between PD and controls throughout the trochlear groove for both cartilaginous (PD vs. control: SA1 166.1° vs. 152.5°, SA2 161.0° vs. 148.5°, SA3 155.7° vs. 145.9°, SA4 150.7° vs. 142.5°) and osseous surfaces (PD vs. control: SA1 160.2° vs. 146.6, SA2 153.8° vs. 140.2°, SA3 147.2° vs. 134.8°, SA4 142.1° vs. 132.6°) ( < 0.001). Diagnostic cutoffs were higher for cartilaginous versus osseous measurements (SA1 159.6° vs. 153.1°, SA2 153.8° vs. 148.0°, SA3 152.5° vs. 141.6°, SA4 148.1° vs. 137.4°). RPD patients had greater cartilaginous SA than OTDs throughout the TG (SA1 = 0.014, SA2 = 0.004, SA3 = 0.027, SA4 = 0.007), while osseous SA measurements did not differ (SA1 = 0.057, SA2 = 0.070, SA3 = 0.185, SA4 = 0.175).
SA was greater in PDs than controls at all four levels in the TG for both cartilaginous and osseous measurements. Cartilaginous SA was greater among RPDs than OTDs at all levels; however, osseous SA was not different between cohorts. The diagnostic cutoff of dysplastic SA differed by axial level and surface.
Level III.
主要目的是评估沟角（SA）的磁共振成像（MRI）测量值，并确定在软骨和骨表面上四个轴向水平的诊断临界值，比较髌骨脱位（PD）患者与对照组。次要目的是确定一次性脱位（OTD）患者与复发性髌骨脱位（RPD）患者之间SA的差异。
对有PD病史的儿科患者进行回顾性分组，分为OTD组和RPD组。确定年龄和性别频率匹配的对照组（无PD病史的前交叉韧带损伤患者）。在滑车沟（TG）的软骨和骨表面的四个水平记录SA。评估样本均值之间的差异（PD组与对照组；RPD组与OTD组）；利用约登指数确定区分PD与对照组的临界值。
共有173例PD患者（106例RPD，67例OTD）和100例对照组。在整个滑车沟中，PD组与对照组之间软骨表面（PD组与对照组：SA1 166.1°对152.5°，SA2 161.0°对148.5°，SA3 155.7°对145.9°，SA4 150.7°对142.5°）和骨表面（PD组与对照组：SA1 160.2°对146.6°，SA2 153.8°对140.2°，SA3 147.2°对134.8°，SA4 142.1°对132.6°）的平均SA存在差异（P＜0.001）。软骨测量的诊断临界值高于骨测量（SA1 159.6°对153.1°，SA2 153.8°对148.0°，SA3 152.5°对141.6°，SA4 148.1°对137.4°）。在整个TG中，RPD患者的软骨SA大于OTD患者（SA1=0.014，SA2=0.004，SA3=0.027，SA4=0.007），而骨SA测量值无差异（SA1=0.057，SA2=0.070，SA3=0.185，SA4=0.175）。
在TG的所有四个水平上，PD患者的软骨和骨测量SA均大于对照组。在所有水平上，RPD患者的软骨SA均大于OTD患者；然而，不同队列之间的骨SA无差异。发育异常SA的诊断临界值因轴向水平和表面而异。
三级。
