2024 · Knee Surgery, Sports Traumatology, Arthroscopy
Can TEA-based 3D CT Measurements Quantify Trochlear Dysplasia?
TG-TEA and MP-MEC were greater in the trochlear dysplasia group in the 0°, 15°, and 30° planes (all P < 0.05).
Original Figure 2
Enlarge FigureWe use 3D CT to reconstruct the shape of the bow and take a steady axis and compare pieces at different heights. It's a way of describing where is narrower than the classification that you see in a side photo.
Joon Young Lee, Sung Eun Kim, Oh Hyo Kwon, Youngjun Kim, Tae-geun Son, Hyuk-Soo Han, Du Hyun Ro. Shallow trochlear groove and narrow medial trochlear width at the proximal trochlea in patients with trochlear dysplasia: A three-dimensional computed tomography analysis. Knee Surgery, Sports Traumatology, Arthroscopy. 2024;32(6):1434–1445. https://doi.org/10.1002/ksa.12166.
Original Figure Legend
Figure 2
Original Figure 3
Enlarge FigureIt's a basic diagram that compares how the gradient pattern changes when the angles of the intersection change. If the measurement position is different, then an indicator with the same name can produce a different value.
Joon Young Lee, Sung Eun Kim, Oh Hyo Kwon, Youngjun Kim, Tae-geun Son, Hyuk-Soo Han, Du Hyun Ro. Shallow trochlear groove and narrow medial trochlear width at the proximal trochlea in patients with trochlear dysplasia: A three-dimensional computed tomography analysis. Knee Surgery, Sports Traumatology, Arthroscopy. 2024;32(6):1434–1445. https://doi.org/10.1002/ksa.12166.
Original Figure Legend
Figure 3
Participants and Methods
Main Findings
The point of reading on surgery
Limitations
Let's put it briefly.
What did this study confirm?
TG-TEA and MP-MEC were greater in the trochlear dysplasia group in the 0°, 15°, and 30° planes (all P < 0.05).
Can it be applied directly to individual patients' treatment decisions?
This was a morphological study. It did not compare the effects of trochleoplasty, MPFL, or TTO techniques. With 20 patients with dysplasia, generalization across subtypes is limited.
Keywords
- quantitative parameter
- three‐dimensional reconstruction
- trochlear dysplasia
- trochlear groove
- trochlear morphology
- Imaging, Three-Dimensional
- Tomography, X-Ray Computed
- Young Adult
Abstract · Original text
Joon Young Lee, Sung Eun Kim, Oh Hyo Kwon, Youngjun Kim, Tae-Geun Son, Hyuk-Soo Han, Du Hyun Ro. Shallow trochlear groove and narrow medial trochlear width at the proximal trochlea in patients with trochlear dysplasia: A three-dimensional computed tomography analysis. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2024;32(6):1434-1445. doi:10.1002/ksa.12166.
PURPOSE
Although the Dejour classification is the primary classification system for evaluating trochlear dysplasia, concerns have been raised about its reliability owing to its qualitative criteria and challenges associated with obtaining accurate radiographs. This study aimed to quantify trochlear dysplasia using three-dimensional (3D) computed tomography (CT) reconstruction with novel parameters related to the transepicondylar axis (TEA).
METHODS
Sixty patients were enrolled, including 20 with trochlear dysplasia and 40 healthy controls. The 3D CT model was generated using the Materialise Interactive Medical Image Control System software. The following six parameters were measured in eight consecutive planes at 15° intervals (planes 0-105): the distance from the TEA to the most cortical point of the lateral condyle ('LP-TEA', where LP stands for lateral peak), medial condyle ('MP-TEA', MP for medial peak) and deepest point of the trochlea ('TG-TEA', TG for trochlear groove). The distances from the medial epicondyle (MEC) to the corresponding TEA points were measured ('LP-MEC', 'MP-MEC' and 'TG-MEC').
RESULTS
In the dysplasia group, TG-TEA (planes 0, 15 and 30) and MP-MEC (planes 0, 15 and 30) were significantly greater than those in the control group (all p < 0.05 for planes of TG-TEA and MP-MEC). For type A dysplasia, LP-MEC (plane 0) was greater than that in the control group. For type B dysplasia, the MP-MEC (planes 0 and 15) and TG-TEA (planes 0 and 15) were greater than those of the control group. For type D dysplasia, MP-MEC (planes 0, 15 and 30) and TG-TEA (planes 0 and 15) were elevated.
CONCLUSION
The 3D CT reconstruction analysis established a reproducible method for quantifying osseous trochlear morphology. Patients with trochlear dysplasia had a shallow TG and narrow medial trochlear width at tracking angles of 0°-30°. This finding corroborates the clinical manifestations of recurrent patellar instability that occur during early flexion.
LEVEL OF EVIDENCE
Level III.
The original paper.
Shallow trochlear groove and narrow medial trochlear width at the proximal trochlea in patients with trochlear dysplasia: A three-dimensional computed tomography analysis
Joon Young Lee, Sung Eun Kim, Oh Hyo Kwon, Youngjun Kim, Tae-Geun Son, Hyuk-Soo Han, Du Hyun Ro
Knee Surgery, Sports Traumatology, Arthroscopy · 2024