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Arthroscopic evaluation of trochlear dysplasia as an aid in decision making for the treatment of patellofemoral instability

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Trochlear dysplasia is an important aetiological factor for the development of patellofemoral instability (PFI). The aim of the study was to identify the arthroscopic morphology of trochlear dysplasia that can be helpful when planning operative treatment for PFI.

Methods

Magnetic resonance imaging (MRI) scans and strict lateral radiographs of 46 patients treated for PFI were assigned according to Dejour and matched with arthroscopic views from the lateral superior arthroscopic portal. On arthroscopy, signs of trochlear dysplasia were identified and classified into two types. Intra- and inter-observer agreements of the arthroscopic evaluation were assessed.

Results

Arthroscopically, 2 major types of trochlear dysplasia could be distinguished. Type I shows a flat trochlear groove with an elevated trochlear floor in relation to the anterior femoral cortex. In type II, the proximal trochlea was convex with a lateral trochlear bump. Arthroscopic evaluation was not consistent with the Dejour’s radiographic and axial MRI classification. Arthroscopic grading showed excellent intra- and inter-observer agreements (81–92 %).

Conclusion

Arthroscopic evaluation can give additional information about the severity of trochlear dysplasia. This additional information can be used as an aid in decision making for the treatment of PFI.

Level of evidence

II.

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Authors and Affiliations

  1. Orthopaedic Specialty Clinic, Clinics Kempten/Oberallgäu, MVZ Oberstdorf, Trettachstrasse 16, 87561, Oberstdorf, Germany

    M. Nelitz

  2. Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany

    S. Lippacher

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  1. M. Nelitz
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  2. S. Lippacher
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Correspondence to M. Nelitz.

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Nelitz, M., Lippacher, S. Arthroscopic evaluation of trochlear dysplasia as an aid in decision making for the treatment of patellofemoral instability. Knee Surg Sports Traumatol Arthrosc 22, 2788–2794 (2014). https://doi.org/10.1007/s00167-013-2586-9

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  • DOI: https://doi.org/10.1007/s00167-013-2586-9

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