The role of the most cranial trochlear orientation in patellar maltracking to better characterise trochlear morphology

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2024-11, Vol.32 (11), p.2909-2918
• Main Authors: Giovannetti de Sanctis, Edoardo, Toanen, Cecile, Guarino, Amedeo, Pineda, Tomas, Deroche, Etienne, Dejour, David H.
• Format: Article
• Language: English
• Subjects: Dejour classification; patella; patellofemoral instability; trochlea; trochlear dysplasia
• ISSN: 0942-2056; 1433-7347; 1433-7347
• DOI: 10.1002/ksa.12314

Purpose The purpose of our study is to describe a magnetic resonance imaging quantitative parameter to assess the morphology of the trochlea that could be measurable from normal to high‐grade trochlear dysplasia while evaluating the most proximal slice with trochlear cartilage. Methods Two groups of patients have been compared: patients with no patellofemoral pain, no previous trauma and undergoing surgery for a suspected isolated meniscal tears (group A) and patients with objective patellar instability (group B). The cranial trochlear orientation (CTO) angle is defined as the angle between the posterior bicondylar line and the most lateral and most medial points on the subchondral bone covered by cartilage digitised on the first and most cranial image with the trochlear cartilage clearly visible. Results The final cohort included 253 patients (109 in group A and 144 in group B). CTO was significantly higher in group B (−2.5 ± 8.4 vs. −10.8 ± 5,1; p  −7°, while 75% of knees in group A had a CTO  0°. All knees with a CTO > 0 were in group B, and 49% of knees with CTO