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Patellar shape can be a predisposing factor in patellar instability.
[trochlear dysplasia]
Predisposing
factors
to
objective
patellar
instability
include
trochlear
dysplasia
,
patella
alta
,
patellar
tilt
and
elevated
tibial
tuberosity-
femoral
groove
distance
.
The
shape
of
the
patella
is
classically
not
considered
a
predisposing
factor
.
Anomalies
of
dynamic
and
static
factors
,
including
excessive
patellar
height
,
tibial
tubercle
lateralisation
or
trochlear
dysplasia
,
may
influence
the
development
of
the
patella
.
One
hundred
and
five
patients
(
140
knees
)
with
objective
patellar
instability
were
retrospectively
reviewed
to
identify
a
possible
association
between
the
above-mentioned
predisposing
factors
and
patellar
shape
.
All
patients
were
evaluated
with
static
and
dynamic
CT
scans
,
and
plain
lateral
and
antero-
posterior
radiographs
,
and
skyline
patellar
views
.
Evidence
of
a
significant
association
emerged
between
patellar
shape
and
patellar
tilt
in
static
(
r
(
s
)
=
0
.
20
,
P
=
0
.
019
)
or
dynamic
conditions
(
r
(
s
)
=
0
.
18
,
P
=
0
.
031
)
and
a
significant
association
between
Wiberg
patellar
shape
type
C
and
trochlear
dysplasia
grade
3
(
χ
(
2
)
=
4
.
5
,
P
=
0
.
035
)
.
Also
,
we
found
a
significant
association
between
trochlear
dysplasia
stage
3
and
tibial
tuberosity-trochlear
groove
(
TT-
TG
)
and
patellar
tilt
relaxed
(
P
<
0
.
01
and
P
<
0
.
05
,
respectively
)
.
There
is
an
association
between
patellar
shape
and
patellar
tilt
.
Increased
lateral
stresses
may
produce
a
Wiberg
type
C
patella
,
with
a
hypoplastic
medial
facet
and
a
more
developed
lateral
facet
.
Unbalance
between
dynamic
medial
and
lateral
stabilisers
may
act
as
an
additional
factor
.
A
rehabilitation
program
aiming
to
reduce
this
unbalance
may
decrease
the
incidence
of
type
C
patella
in
young
patients
.
Diseases
Validation
Diseases presenting
"elevated tibial tuberosity-femoral groove distance"
symptom
trochlear dysplasia
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