High Femoral Anteversion Is Related to Femoral Trochlea Dysplasia

Purpose To investigate the possible relation between femoral anteversion (AV) and trochlear morphology. Methods Among 560 available lower-limb computed tomography (CT) scans, those with previous fracture, arthroplasty, or osteotomy were excluded and 40 cases were randomly selected. The following 4 l...

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Veröffentlicht in:Arthroscopy 2016-11, Vol.32 (11), p.2295-2299
Hauptverfasser: Liebensteiner, Michael Christian, M.D., Ph.D, Ressler, Julia, Seitlinger, Gerd, M.D, Djurdjevic, Tanja, M.D, El Attal, Rene, M.D, Ferlic, Peter Wilhelm, M.D
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Sprache:eng
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Zusammenfassung:Purpose To investigate the possible relation between femoral anteversion (AV) and trochlear morphology. Methods Among 560 available lower-limb computed tomography (CT) scans, those with previous fracture, arthroplasty, or osteotomy were excluded and 40 cases were randomly selected. The following 4 lines were determined from the CT scans: 1 through the center of the femoral head and neck; 1 through the lesser trochanter and the center of the femoral shaft; 1 as a tangent to the dorsal part of the distal femur, just above the gastrocnemius insertion; and 1 as a tangent to the posterior condyles. Between the respective lines, the following parameters of femoral AV were determined: (1) total AV, (2) proximal AV, (3) diaphyseal AV, and (4) distal AV. Trochlea parameters were determined from 2 separate axial CT slices (proximal trochlea and 5 mm farther distally): trochlea height (medial, central, lateral), transverse trochlea shift, trochlea depth, sulcus angle, lateral trochlea slope, and Dejour trochlea type. To prove or disprove our study hypothesis, a correlation analysis was performed between the variables of AV and trochlear morphology. Results The total AV was significantly correlated with the trochlea parameters trochlea depth ( P  = .032), sulcus angle ( P  = .05), and lateral trochlea slope ( P  = .001). The diaphyseal AV was significantly correlated with the sulcus angle ( P  = .009). The distal AV showed significant correlations with medial, central, and lateral trochlea height (.005 < P < .032) and with Dejour trochlea type ( P  = .043). Conclusions The morphology of the trochlea is significantly related to femoral AV. Increased AV is associated with a flatter, more dysplastic trochlea. This was particularly true for AV located at the distal femur. Level of Evidence Level III, diagnostic study of nonconsecutive patients.
ISSN:0749-8063
1526-3231
DOI:10.1016/j.arthro.2016.03.023