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Landmarks of the normal adult human trochlea based on axial MRI measurements: a cross-sectional study.
[trochlear dysplasia]
For
deepening
trochleoplasty
,
a
procedure
used
worldwide
to
correct
trochlear
dysplasia
,
only
few
surgical
steps
are
described
precisely
.
Important
surgical
landmarks
,
such
as
optimal
cartilaginous
trochlear
depth
and
percentages
of
the
new
lateral
and
medial
facet
,
remain
unanswered
.
A
cross-sectional
study
(
January
2011
-
August
2012
)
was
carried
out
in
adult
patients
(
16
-
35
years
)
without
trochlear
dysplasia
,
who
underwent
magnetic
resonance
imaging
(
MRI
)
.
The
main
outcome
was
trochlear
depth
.
The
secondary
outcome
was
the
lateral
/
medial
facet
ratio
.
Measurements
were
made
on
the
first
axial
cut
from
proximal
with
complete
cartilage
coverage
of
the
trochlea
.
Differences
between
men
and
women
were
assessed
.
Fifty
-
three
patients
(
70
%
men
)
were
included
.
Mean
age
was
24
.
6
years
(
SD
±
5
.
5
)
.
Overall
mean
trochlear
depth
was
found
to
be
as
4
.
0
mm
(
95
%
CI
3
.
6
-
4
.
3
)
.
Values
differed
significantly
by
gender
(
p
=
0
.
0271
)
with
a
mean
of
3
.
4
mm
(
95
%
CI
3
.
0
-
3
.
8
)
for
women
and
a
mean
of
4
.
2
mm
(
95
%
CI
3
.
8
-
4
.
7
)
for
men
.
The
mean
ratio
between
the
lateral
and
medial
facet
was
1
.
71
(
95
%
CI
1
.
62
-
1
.
80
)
,
the
lateral
facet
contributing
62
.
6
%
(
95
%
CI
61
.
3
-
63
.
8
)
and
the
medial
facet
contributing
37
.
4
%
(
95
%
CI
36
.
2
-
38
.
7
)
to
the
total
cartilage
length
.
For
the
facet
ratio
,
there
was
no
statistically
significant
gender
difference
(
n
.
s
.
)
.
This
study
provides
data
on
important
landmarks
for
deepening
trochleoplasty
based
on
average
MRI
measurements
in
the
general
population
.
The
difference
between
the
MRI
measurement
and
actual
cartilage
surface
measurement
is
likely
to
be
minimal
,
but
is
yet
to
be
evaluated
.
Further
evaluation
of
these
landmarks
by
prospectively
performing
deepening
trochleoplasty
will
determine
the
value
of
the
clinical
implication
.
II
.
Diseases
Validation
Diseases presenting
"complete cartilage coverage of the trochlea"
symptom
trochlear dysplasia
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