The prevalence of radiographic trochlear dysplasia in patients with patellar fractures
Abstract Purpose Trochlear dysplasia is found in 3.2% (95% confidence interval (CI) 1.2–6.7) of the general population and linked to patellar instability and anterior cruciate ligament (ACL) injuries. The purpose of this study was to evaluate the prevalence of radiographic trochlear dysplasia in pat...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-12-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-024-08204-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559892984332288 |
|---|---|
| author | Vanessa Morello Matthieu Zingg Philippe Tscholl |
| author_facet | Vanessa Morello Matthieu Zingg Philippe Tscholl |
| author_sort | Vanessa Morello |
| collection | DOAJ |
| description | Abstract Purpose Trochlear dysplasia is found in 3.2% (95% confidence interval (CI) 1.2–6.7) of the general population and linked to patellar instability and anterior cruciate ligament (ACL) injuries. The purpose of this study was to evaluate the prevalence of radiographic trochlear dysplasia in patients with patellar fractures. Secondary outcome was to evaluate the prevalence of trochlear dysplasia in different type of patellar fracture. Methods All consecutive 18-year-old or older patients treated in a level-1 trauma center for patellar fracture between 2003 and 2016 were retrospectively evaluated. Trochlear dysplasia was assessed according to Dejour’s classification on a strict lateral knee x-ray. Patellar fractures were analyzed on AP, lateral and axial knee x-rays and classified on pattern and displacement. Patellar dislocation at time of injury was recorded. Results Out of 482 patellar fractures, a strict lateral knee x-ray was found in 166 cases (50.6% women, mean age 56years +/-21, 51% right knee). Nineteen cases had trochlear dysplasia (11.5%, 95% CI 6.9–17.9): 10 high-grade trochlear dysplasia meaning type B, C and D (6.0%, 95% CI 2.4–9.7%); 15 without dislocation (9.3%, 95% CI 5.2–15.3). Patellar fracture distribution showed 17 transverse non-displaced (10.2%), 38 transverse displaced (22.9%), 15 avulsion (9%), 27 multifragmented non-displaced (16.3%), 56 multi-fragmented displaced (33.7%), 7 vertical (4.2%) and 6 osteochondral (3.6%) fractures. Four dislocations were recorded, all had osteochondral fractures and trochlear dysplasia. When considering patellar fractures with dislocation, the incidence of osteochondral lesions was significantly higher in patients with trochlear dysplasia (p < 0.001). This is not true for any other type of patellar fracture (p = 0.138). Conclusions This study suggests that there is a significant prevalence of trochlear dysplasia in patients with patellar fractures. This study also suggests that the pattern of patellar fracture is not influenced by the presence of trochlear dysplasia, except for osteochondral fractures associated with patello-femoral dislocations. |
| format | Article |
| id | doaj-art-874c2da348944f939e006d8d1e36d5eb |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-874c2da348944f939e006d8d1e36d5eb2025-01-05T12:04:43ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-012511610.1186/s12891-024-08204-4The prevalence of radiographic trochlear dysplasia in patients with patellar fracturesVanessa Morello0Matthieu Zingg1Philippe Tscholl2Division of Orthopaedic and Trauma Surgery, University Hospitals of GenevaDivision of Orthopaedic and Trauma Surgery, University Hospitals of GenevaDivision of Orthopaedic and Trauma Surgery, University Hospitals of GenevaAbstract Purpose Trochlear dysplasia is found in 3.2% (95% confidence interval (CI) 1.2–6.7) of the general population and linked to patellar instability and anterior cruciate ligament (ACL) injuries. The purpose of this study was to evaluate the prevalence of radiographic trochlear dysplasia in patients with patellar fractures. Secondary outcome was to evaluate the prevalence of trochlear dysplasia in different type of patellar fracture. Methods All consecutive 18-year-old or older patients treated in a level-1 trauma center for patellar fracture between 2003 and 2016 were retrospectively evaluated. Trochlear dysplasia was assessed according to Dejour’s classification on a strict lateral knee x-ray. Patellar fractures were analyzed on AP, lateral and axial knee x-rays and classified on pattern and displacement. Patellar dislocation at time of injury was recorded. Results Out of 482 patellar fractures, a strict lateral knee x-ray was found in 166 cases (50.6% women, mean age 56years +/-21, 51% right knee). Nineteen cases had trochlear dysplasia (11.5%, 95% CI 6.9–17.9): 10 high-grade trochlear dysplasia meaning type B, C and D (6.0%, 95% CI 2.4–9.7%); 15 without dislocation (9.3%, 95% CI 5.2–15.3). Patellar fracture distribution showed 17 transverse non-displaced (10.2%), 38 transverse displaced (22.9%), 15 avulsion (9%), 27 multifragmented non-displaced (16.3%), 56 multi-fragmented displaced (33.7%), 7 vertical (4.2%) and 6 osteochondral (3.6%) fractures. Four dislocations were recorded, all had osteochondral fractures and trochlear dysplasia. When considering patellar fractures with dislocation, the incidence of osteochondral lesions was significantly higher in patients with trochlear dysplasia (p < 0.001). This is not true for any other type of patellar fracture (p = 0.138). Conclusions This study suggests that there is a significant prevalence of trochlear dysplasia in patients with patellar fractures. This study also suggests that the pattern of patellar fracture is not influenced by the presence of trochlear dysplasia, except for osteochondral fractures associated with patello-femoral dislocations.https://doi.org/10.1186/s12891-024-08204-4Trochlear dysplasiaPatellar fractureKneePatello-femoral jointPatello-femoral dislocation |
| spellingShingle | Vanessa Morello Matthieu Zingg Philippe Tscholl The prevalence of radiographic trochlear dysplasia in patients with patellar fractures BMC Musculoskeletal Disorders Trochlear dysplasia Patellar fracture Knee Patello-femoral joint Patello-femoral dislocation |
| title | The prevalence of radiographic trochlear dysplasia in patients with patellar fractures |
| title_full | The prevalence of radiographic trochlear dysplasia in patients with patellar fractures |
| title_fullStr | The prevalence of radiographic trochlear dysplasia in patients with patellar fractures |
| title_full_unstemmed | The prevalence of radiographic trochlear dysplasia in patients with patellar fractures |
| title_short | The prevalence of radiographic trochlear dysplasia in patients with patellar fractures |
| title_sort | prevalence of radiographic trochlear dysplasia in patients with patellar fractures |
| topic | Trochlear dysplasia Patellar fracture Knee Patello-femoral joint Patello-femoral dislocation |
| url | https://doi.org/10.1186/s12891-024-08204-4 |
| work_keys_str_mv | AT vanessamorello theprevalenceofradiographictrochleardysplasiainpatientswithpatellarfractures AT matthieuzingg theprevalenceofradiographictrochleardysplasiainpatientswithpatellarfractures AT philippetscholl theprevalenceofradiographictrochleardysplasiainpatientswithpatellarfractures AT vanessamorello prevalenceofradiographictrochleardysplasiainpatientswithpatellarfractures AT matthieuzingg prevalenceofradiographictrochleardysplasiainpatientswithpatellarfractures AT philippetscholl prevalenceofradiographictrochleardysplasiainpatientswithpatellarfractures |