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Evidence of trochlear dysplasia in patellofemoral arthroplasty designs.
[trochlear dysplasia]
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
.
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
.
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
°
)
.
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
.
III
.
Diseases
Validation
Diseases presenting
"arthritis"
symptom
acute rheumatic fever
child syndrome
congenital adrenal hyperplasia
cystinuria
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
harlequin ichthyosis
homocystinuria without methylmalonic aciduria
inclusion body myositis
lamellar ichthyosis
malignant atrophic papulosis
pyomyositis
sneddon syndrome
trochlear dysplasia
typhoid
wiskott-aldrich syndrome
This symptom has already been validated