A validated cadaveric model of trochlear dysplasia

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

Research output: Contribution to journalArticle

8 Scopus citations

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 - Sep 1 2014

Keywords

  • Cadaveric biomechanics
  • Cadaveric model
  • Patellar instability
  • Trochlear depth
  • Trochlear dysplasia
  • Trochleoplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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  • Cite this

    Latt, L. D., 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