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Anatomy of lateral patellar instability: trochlear dysplasia and tibial tubercle-trochlear groove distance is more pronounced in women who dislocate the patella.
[trochlear dysplasia]
A
trend
toward
young
women
being
at
greatest
risk
for
primary
and
recurrent
dislocation
of
the
patella
is
evident
in
the
current
literature
.
However
,
a
causative
factor
is
missing
,
and
differences
in
the
anatomical
risk
factors
between
men
and
women
are
less
defined
.
To
identify
differences
between
the
sexes
in
the
anatomy
of
lateral
patellar
instability
.
Case
control
study
;
Level
of
evidence
,
3
.
Knee
magnetic
resonance
images
were
collected
from
100
patients
treated
for
lateral
patellar
instability
.
Images
were
obtained
from
157
patients
without
patellar
instability
who
served
as
controls
.
Using
2
-
way
analyses
of
variance
,
the
influence
of
patellar
dislocation
,
gender
,
and
their
interaction
were
analyzed
with
regard
to
sulcus
angle
,
trochlear
depth
,
trochlear
asymmetry
,
patellar
height
,
and
the
tibial
tubercle-trochlear
groove
(
TT-
TG
)
distance
.
Mechanisms
of
injury
of
first
-time
dislocations
were
divided
into
high
-risk
,
low
-risk
,
and
no
-risk
pivoting
activities
and
direct
hits
.
For
all
response
variables
,
a
significant
effect
was
observed
for
the
incidence
of
patellar
dislocation
(
all
P
<
.
01
)
.
In
addition
,
sulcus
angle
,
trochlear
asymmetry
,
and
trochlear
depth
depended
significantly
on
gender
(
all
P
<
.
01
)
but
patellar
height
did
not
(
P
=
.
13
)
.
A
significant
interaction
between
patellar
dislocation
and
gender
was
observed
for
the
TT-
TG
distance
(
P
=
.
02
)
.
The
mean
difference
in
TT-
TG
distance
between
study
and
control
groups
was
4
.
1
mm
for
women
(
P
<
.
01
)
and
1
.
6
mm
for
men
(
P
=
.
05
)
.
Low
-risk
and
no
-risk
pivoting
injuries
were
most
common
in
women
,
whereas
first
-time
dislocations
in
men
occurred
mostly
during
high
-risk
pivoting
activities
(
P
<
.
01
)
.
The
data
from
this
study
indicate
that
trochlear
dysplasia
and
the
TT-
TG
distance
is
more
prominent
in
women
who
dislocate
the
patella
.
Both
factors
might
contribute
to
an
increased
risk
of
lateral
patellar
instability
in
the
female
patient
as
illustrated
by
the
fact
that
dislocations
occurred
most
often
during
low
-risk
or
no
-risk
pivoting
activities
in
women
.
Diseases
Validation
Diseases presenting
"patellar instability"
symptom
trochlear dysplasia
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