Medial orientation of the trochlear groove is a strong indicator of high‐grade trochlear dysplasia

Abstract

AbstractPurposeThe 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.MethodsFrom 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.ResultsA 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]°).ConclusionPatients 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.Study designCase–control study.Level of EvidenceLevel III.