Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2014
Evidence of trochlear dysplasia in patellofemoral arthroplasty designs.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Saffarini Mo, Ntagiopoulos Panagiotis G, Demey Guillaume, Le Negaret Benoit, Dejour David H
Аннотация
PURPOSE: The design of the trochlear compartment is crucial in patellofemoral arthroplasty (PFA), because 78% of patients with isolated patellofemoral arthritis present concomitant trochlear dysplasia with patellar maltracking and therefore remain predisposed to post-operative patellar subluxation and dislocation. The study investigated whether current PFA implants are designed with anatomic trochlear parameters such as the sulcus angle, lateral facet height and groove orientation.
METHODS: Five trochlear components of commercially available PFA implants were scanned, and the generated three-dimensional surfaces were measured using engineering design software. The mediolateral trochlear profiles were plotted at various flexion angles (0°, 15°, 30° and 45°) to deduce the following variables: sulcus angle, height of lateral facet and trochlear groove orientation.
RESULTS: Four specimens had sulcus angle>144° in the 45° of flexion, and all five specimens had sulcus angle>143° in 30° of flexion. Three specimens had a facet<5 mm high through the entire range of early flexion (0°-30°), and two specimens had a facet<5 mm high beyond early flexion (30°-45°). The trochlear groove was oriented laterally in all specimens (range 1.6°-13.5°).
CONCLUSION: Current PFA trochlear components are not always designed with anatomic parameters, and some models exhibit characteristics of trochlear dysplasia. Surgeons are therefore advised to implant components with a deep sulcus, particularly in patients with history of patellofemoral disorders, and to adapt the surgical technique and extensor mechanism if the component implanted has a shallow sulcus, to ensure normal patellar tracking.
LEVEL OF EVIDENCE: III.
METHODS: Five trochlear components of commercially available PFA implants were scanned, and the generated three-dimensional surfaces were measured using engineering design software. The mediolateral trochlear profiles were plotted at various flexion angles (0°, 15°, 30° and 45°) to deduce the following variables: sulcus angle, height of lateral facet and trochlear groove orientation.
RESULTS: Four specimens had sulcus angle>144° in the 45° of flexion, and all five specimens had sulcus angle>143° in 30° of flexion. Three specimens had a facet<5 mm high through the entire range of early flexion (0°-30°), and two specimens had a facet<5 mm high beyond early flexion (30°-45°). The trochlear groove was oriented laterally in all specimens (range 1.6°-13.5°).
CONCLUSION: Current PFA trochlear components are not always designed with anatomic parameters, and some models exhibit characteristics of trochlear dysplasia. Surgeons are therefore advised to implant components with a deep sulcus, particularly in patients with history of patellofemoral disorders, and to adapt the surgical technique and extensor mechanism if the component implanted has a shallow sulcus, to ensure normal patellar tracking.
LEVEL OF EVIDENCE: III.