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Arthroscopic evaluation of trochlear dysplasia as an aid in decision making for the treatment of patellofemoral instability.
[trochlear dysplasia]
Trochlear
dysplasia
is
an
important
aetiological
factor
for
the
development
of
patellofemoral
instability
(
PFI
)
.
The
aim
of
the
study
was
to
identify
the
arthroscopic
morphology
of
trochlear
dysplasia
that
can
be
helpful
when
planning
operative
treatment
for
PFI
.
Magnetic
resonance
imaging
(
MRI
)
scans
and
strict
lateral
radiographs
of
46
patients
treated
for
PFI
were
assigned
according
to
Dejour
and
matched
with
arthroscopic
views
from
the
lateral
superior
arthroscopic
portal
.
On
arthroscopy
,
signs
of
trochlear
dysplasia
were
identified
and
classified
into
two
types
.
Intra-
and
inter-observer
agreements
of
the
arthroscopic
evaluation
were
assessed
.
Arthroscopically
,
2
major
types
of
trochlear
dysplasia
could
be
distinguished
.
Type
I
shows
a
flat
trochlear
groove
with
an
elevated
trochlear
floor
in
relation
to
the
anterior
femoral
cortex
.
In
type
II
,
the
proximal
trochlea
was
convex
with
a
lateral
trochlear
bump
.
Arthroscopic
evaluation
was
not
consistent
with
the
Dejour
's
radiographic
and
axial
MRI
classification
.
Arthroscopic
grading
showed
excellent
intra-
and
inter-observer
agreements
(
81
-
92
Â
%
)
.
Arthroscopic
evaluation
can
give
additional
information
about
the
severity
of
trochlear
dysplasia
.
This
additional
information
can
be
used
as
an
aid
in
decision
making
for
the
treatment
of
PFI
.
II
.
Diseases
Validation
Diseases presenting
"important aetiological factor for the development"
symptom
trochlear dysplasia
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