A validated cadaveric model of trochlear dysplasia

Daniel L Latt, M. Christopher, A. Nicolini, D. R. Burk, B. Dezfuli, B. J. Serack, D. C. Fithian

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

PURPOSE: Despite the high prevalence of trochlear dysplasia among patients with patellar instability, it is not well studied and is infrequently addressed surgically. The lack of a validated cadaveric model of trochlear dysplasia may be a contributing factor. The goal of this study was to develop a simple, reproducible, and realistic cadaveric model of trochlear dysplasia by surgically modifying cadaveric femora with normal anatomy and then to validate this model through the use of mechanical and fluoroscopic measurements.

METHODS: The floor of the trochlear groove was surgically elevated using an inflatable bone tamp in eight cadaveric femora. The trochlear depth (TD) was measured with a custom-designed measuring device, and radiographic markers of dysplasia (sulcus angle, crossing sign, and prominence) were assessed before and after surgical modification.

RESULTS: The average TD was 3.6±1.4, 4.6±1.1, and 5.1±1.0 mm prior to reverse trochleoplasty (RT) and 1.0±1.8, 2.3±1.3, and 3.3±2.5 mm following RT at 0°, 20°, and 40° of flexion, respectively. These direct measurements of TD were confirmed with fluoroscopy. The sulcus angle averaged 141° prior to RT and 157° after RT. The average prominence across all specimens was 3.3±0.7 mm before RT, and 5.5±1.5 mm after RT. Finally, the crossing sign was found to be absent in all knees prior to RT and present in 7 of the 8 after RT.

CONCLUSIONS: The results of this study show that elevation of the trochlear floor with an inflatable bone tamp can reproducibly create a simulated dysplastic trochlea. This model may be useful in biomechanical studies of treatments for patellofemoral instability.

Original languageEnglish (US)
Pages (from-to)2357-2363
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume22
Issue number10
DOIs
StatePublished - Oct 1 2014

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Femur
Bone and Bones
Fluoroscopy
Knee
Anatomy
Equipment and Supplies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Latt, D. L., Christopher, M., Nicolini, A., Burk, D. R., Dezfuli, B., Serack, B. J., & Fithian, D. C. (2014). A validated cadaveric model of trochlear dysplasia. Knee Surgery, Sports Traumatology, Arthroscopy, 22(10), 2357-2363. https://doi.org/10.1007/s00167-014-3033-2

A validated cadaveric model of trochlear dysplasia. / Latt, Daniel L; Christopher, M.; Nicolini, A.; Burk, D. R.; Dezfuli, B.; Serack, B. J.; Fithian, D. C.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 22, No. 10, 01.10.2014, p. 2357-2363.

Research output: Contribution to journalArticle

Latt, DL, Christopher, M, Nicolini, A, Burk, DR, Dezfuli, B, Serack, BJ & Fithian, DC 2014, 'A validated cadaveric model of trochlear dysplasia', Knee Surgery, Sports Traumatology, Arthroscopy, vol. 22, no. 10, pp. 2357-2363. https://doi.org/10.1007/s00167-014-3033-2
Latt DL, Christopher M, Nicolini A, Burk DR, Dezfuli B, Serack BJ et al. A validated cadaveric model of trochlear dysplasia. Knee Surgery, Sports Traumatology, Arthroscopy. 2014 Oct 1;22(10):2357-2363. https://doi.org/10.1007/s00167-014-3033-2
Latt, Daniel L ; Christopher, M. ; Nicolini, A. ; Burk, D. R. ; Dezfuli, B. ; Serack, B. J. ; Fithian, D. C. / A validated cadaveric model of trochlear dysplasia. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2014 ; Vol. 22, No. 10. pp. 2357-2363.
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AB - PURPOSE: Despite the high prevalence of trochlear dysplasia among patients with patellar instability, it is not well studied and is infrequently addressed surgically. The lack of a validated cadaveric model of trochlear dysplasia may be a contributing factor. The goal of this study was to develop a simple, reproducible, and realistic cadaveric model of trochlear dysplasia by surgically modifying cadaveric femora with normal anatomy and then to validate this model through the use of mechanical and fluoroscopic measurements.METHODS: The floor of the trochlear groove was surgically elevated using an inflatable bone tamp in eight cadaveric femora. The trochlear depth (TD) was measured with a custom-designed measuring device, and radiographic markers of dysplasia (sulcus angle, crossing sign, and prominence) were assessed before and after surgical modification.RESULTS: The average TD was 3.6±1.4, 4.6±1.1, and 5.1±1.0 mm prior to reverse trochleoplasty (RT) and 1.0±1.8, 2.3±1.3, and 3.3±2.5 mm following RT at 0°, 20°, and 40° of flexion, respectively. These direct measurements of TD were confirmed with fluoroscopy. The sulcus angle averaged 141° prior to RT and 157° after RT. The average prominence across all specimens was 3.3±0.7 mm before RT, and 5.5±1.5 mm after RT. Finally, the crossing sign was found to be absent in all knees prior to RT and present in 7 of the 8 after RT.CONCLUSIONS: The results of this study show that elevation of the trochlear floor with an inflatable bone tamp can reproducibly create a simulated dysplastic trochlea. This model may be useful in biomechanical studies of treatments for patellofemoral instability.

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