abnormal trochlear morphology according to the widely used Dejour classification system.3,24 In the Dejour system, trochlear dysplasia is classified using lateral radio-graphs as types A through D depending on the presence of a crossing sign, supratro-chlear spur, and/or a double contour (Figs. 1 and 2). The Dejour grade not only help . Dejour's classification). Fig. 3 Lateral view radiograph sho wing the trochlear bump. The yellow line is a straight line tangential to the anterior
The lateral trochlear sign: femoral trochlear dysplasia as seen on a lateral view roentgenograph. Clin Orthop 1992; 281:159-162. Medline, Google Scholar; 14 Dejour H, Walch G, Neyret P, Adeleine P. Dysplasia of the femoral trochlea. Rev Chir Orthop Reparatrice Appar Mot 1990; 76:45-54. Medline, Google Schola Background: The assessment and classification of trochlear dysplasia in pediatric patients has yet to be well documented or validated. Purpose: To examine sever..
Background: Trochlear dysplasia is known to be an important cause of patellofemoral instability. D. Dejour's radiographic and magnetic resonance imaging (MRI) classifications are widely used in clinical practice and in the orthopaedic literature to assess the severity of trochlear dysplasia Sie wird nach Dejour in vier Typen mit steigendem Risiko für eine Patellaluxation unterteilt. In einer radiologischen Untersuchung konnte gezeigt werden, dass die Patellaform nicht durch eine bestehende Trochleadysplasie beeinflusst wird. Hierdurch erklärt sich der durch die fehlende Kongruenz zwischen Trochlea und Patella verursachte. .05). No quantitative measurement differentiated between trochlear dysplasia of Dejour types C and D
Dejour et al. 14 believed that trochlear dysplasia was a congenital alteration that would be a predisposing factor favoring femoropatellar instability. If this were so, trochlear dysplasia might be found in young patients who had not developed instability, which was not seen in the sample studied here Patients with persistent apprehension had a larger Caton-Deschamps index on average, were more likely to have more severe trochlear dysplasia (of Dejour B, C or D), had a higher sulcus angle. Trochlear dysplasia (TD) is a major predisposing factor for patellar dislocation. Researches by Dejour and Fulkerson et al. had reported that trochlear dysplasia existed in 96% of patients with a history of patellar dislocation . The prominent features of trochlear dysplasia are the flat trochlear sulcus or irregular trochlear facets
CT scanning confirms the trochlear flatness and the trochlear prominence on sagittal sections, which can also be measured (Figure 6) according to David Dejour's classification .It is important to consider that the dysplastic trochlea is lateralized compared to the center of the femoral epiphysis Trochlear dysplasia is considered to be one of the major factors causing patellofemoral instability (PFI). Dejour's classification is widely used to assess the severity of trochlear dysplasia. Additionally, in current literature, different quantitative parameters are recommended to distinguish between a normal trochlea and a dysplastic trochlea The effect of trochlear dysplasia on patellofemoral biomechanics: a cadaveric study with simulated trochlear deformities. Van Haver A, De Roo K, De Beule M, Labey L, De Baets P, Dejour D, Claessens T, Verdonk P. Am J Sports Med. 2015 Jun;43(6):1354-61. Trochlear dysplasia: imaging and treatment options Many studies have reported satisfactory clinical outcomes and low redislocation rates after reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of lateral patellar instability. Despite uncorrected severe trochlear dysplasia (Dejour type B to D) being acknowledged.
Trochlear dysplasia is a known risk factor for patellar instability. Maldegue and Malghem used a strictly lateral radiograph of the knee to analyse the trochlear depth . Dejour et al. deﬁned three types of dysplasia (I-III) using a strictly lateral knee radiograph and reported that trochlear dysplasia is prevalent in 85% in patients. Trochlear depth (TD) measures the depth of the trochlear groove in relation to the femoral condyles. Usage Trochlear depth (TD) is used for the assessment of trochlear dysplasia, a dysplastic deformity of the femoral head, which is known risk f.. MEaSurEMEnt oF troChLEar DySPLaSia Knees were subdivided into groups based on the de-gree of femoral trochlear dysplasia evaluated according to Dejour & Saggin's criteria  and validated by Lippacher et al.  (Table 1). First, a two-grade analysis of knees was conducted using pre-operative axial CT scans of pa-tient knees
Lippacher S, Dejour D, Elsharkawi M, Dornacher D, Ring C, Dreyhaupt J, Reichel H and Nelitz M. Observer Agreement on the Dejour Trochlear Dysplasia Classification: A Comparison of True Lateral Radiographs and Axial Magnetic Resonance Images. Am J Sports Med 2012;40(4):837-843. Matthew Bollier MD, John P. Fulkerson MD Sinónimos: Hipoplasia de la tróclea femoral Insuficiencia del surco troclear femoral. Prevalencia: Desconocido Herencia: Desconocido Edad de inicio o aparición: Cualquier edad Resumen. La displasia troclear femoral es una anomalía anatómica de la rodilla caracterizada por una geometría anormal de la parte femoral de la articulación patelofemoral subchondral bone to create a groove in gross trochlear dysplasia, with the groove created by impaction. In 1995, Reynaud  reported the results of 40 patients who underwent a modification of the Masse operation performed by Dejour et al. . Recently Verdonk et al. have reporte The DeJour classification of trochlear dysplasia (images 14-17) is determined by combining slice imaging (CT or MRI) with the true lateral X-ray, and categorised by the presence of a crossing sign (type A), supratrochlear spur (type B), double contour sign (type C), or combinations of type A-C (type D)
Dejour D, Ntagiopoulos PG, Saffarini M. Evidence of trochlear dysplasia in femoral component designs. Knee Surg Sports Traumatol Arthrosc 2014;22:2599-607. Saffarini M, Ntagiopoulos PG, Demey G, et al. Evidence of trochlear dysplasia in patellofemoral arthroplasty designs. Knee Surg Sports Traumatol Arthrosc 2014;22:2574-81 Trochlear dysplasia has been identified as one of the main factors contributing to chronic patellofemoral instability. In individuals with trochlear dysplasia, the trochlear joint surface Dejour# et al proposed a classification distinguishing four morphologic types of trochlear dysplasia: Four types of trochlear dysplasia, according to the classification of Dejour et al (19,20), on fat-saturated T2-weighted MR images. (a) Axial image shows type A dysplasia: Trochlear morphologic structures are preserved, but the sulcus is shallow. (b) Axial image shows type B dysplasia: flat, horizontally oriented trochlear joint surface trochlear dysplasia, DeJour said. It has become well established as a very high instability factor. Patella alta is a chief factor for patellar instability. Those in the Lyon school contend it is amenable to surgical correction when it is larger than 1.2 mm The condition of having a shallow groove is called trochlear dysplasia or dysplatic trochlea (abnormal groove). In these cases were you groove is flat, this operation called trochleoplasty, is the best option for you. If you have a shallow groove
Trochlear facet asymmetry 55.03%±14.51% 61.30%±14.16% 0.000 Lateral trochlear inclination 18.36±4.72 19.53±4.79 0.001 ACL, anterior cruciate ligament; FTD, femoral trochlear dysplasia. Table 1 Comparison of the number of Dejour types between the ACL injury group and control group Dejour type The ACL injury group (n=423) The control group (n. Dejour et al. defined femoral trochlear dysplasia by one qualitative (the crossing sign) and two quantitative (trochlear bump and trochlear depth) features on true lateral radiographs. Pfirrmann et al. [ 14 ] used this classification to study the femoral trochlea on MRI
Trochlear dysplasia is a major predisposing factor of patellar instability (PI). Dysplasia types are generally evaluated on one axial plane using Dejour classification, but it is unclear whether this classification covers the entire spectrum. Purpos The Dejour classification is currently considered the standard for classifying trochlear dysplasia, but numerous studies have reported poor reliability on both plain radiography and MRI. The severity of trochlear dysplasia is important to establish in order to guide surgical management • The trochlear bump or prominence is measured by the distance between a line tangential to the anterior femoral cor-tex, and a line parallel to this through the trochlear groove. A bump > 5 mm char-acterizes a major dysplasia (Figure 4) • Patellar height may also be determined to consider an ATTT distalization pro-cedure 3D models can increase accuracy for detection of patellofemoral dysplasia. For Dejour classification, 3D models and radiographs/CT show similar performances. Inter-reader reliabilities are similar of 3D model and radiograph/CT assessments. Results: Trochlear dysplasia was present in 28/50 patients. Evaluations of 3D-models vs. CR/CT for. Trochlear dysplasia: Introduction. Trochlear dysplasia: An unstable kneecap due to abnormal development of the kneecap. More detailed information about the symptoms, causes, and treatments of Trochlear dysplasia is available below.. Symptoms of Trochlear dysplasia
evaluate for trochlear dysplasia; values > 140 degrees indicate flattening of the trochlea concerning for dysplasia ; CT scan. TT-TG distance . measures the distance between 2 perpendicular lines from the posterior cortex to the tibial tubercle and the trochlear groove >20mm usually considered abnormal ; MRI . help further rule out suspected. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Read it here Observer agreement on the Dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images The patient inclusion criteria were a medical history of >1 patellar dislocation prior to admission and CT images of knees suggesting severe trochlear dysplasia as Dejour types B-D, which were determined according to the Dejour trochlear dysplasia system . Exclusion criteria were as follows: Osteoarthritis, meniscus tears, metabolic bone. Trochlear dysplasia was well evaluated and graded by Dejour using images. 13 Assisted by radiography and CT scans, Dejour 14 classified dysplasia in types A, B, C and D 15 . Fig. 1 Dejour classification of trochlear dysplasia 14 (radiography and computed tomography scan)
Two knees were classified as low-grade trochlear dysplasia (Dejour A) and 35 as high-grade trochlear dysplasia (Dejour B-D). At final follow-up, patients reported mean KOOS subscale scores of 86.5 (Pain), 79.8 (Symptoms), 93.9 (Activities of Daily Living), 74.3 (Sports/Recreation), and 61.9 (Quality of Life), as well as a mean Kujala score of 81.3 Trochlear dysplasia is known to be a major risk factor for patellofemoral instability. Dejour et al. [ 9 ] found that 96 % of patients with a history of a true patellar dislocation had evidence of trochlear dysplasia. In 1989, Walch and Dejour [ 24 ] described the lateral trochlear sign on lateral radiographs, which was later called the crossing sign, as a parameter for trochlear dysplasia. Current Concepts in Trochleoplasty for Major Trochlear Dysplasia. Reconstructive Review, Dec 2013 Philippe Beaufils, Mathieu Thaunat, Nicolas Pujol, Sven Scheffler, Roberto Rossi, Mike Carmont. Philippe Beaufils. Mathieu Thaunat. Nicolas Pujol. Sven Scheffler.
(2)Quadriceps dysplasia (83%), defined as present when the patellar tilt in extension is more than 20% on the CT scans. (3)Patella alta (Caton-Deschamps) index greater than or equal to 1.2 (24%). (4)Tibial tuberosity-trochlear groove, pathological when greater than or equal to 20 mm (56%). The factors appeared in only 3%-6.5% of the control. Standard MRI clearly showed a high-grade trochlear dysplasia type C according to Dejour 2 with a previously ruptured MPFL and no detectable cartilage damage (Fig. 4). The tibial tuberosity to trochlear groove (TTTG) distance was 10.1 mm. MR imaging of the contralateral knee illustrated normal patellofemoral articulation, normal MPFL and a TTTG. Philip Schoettle. Patient with grade 4 central groove trochlear defect. Speaker #4. David DeJour. Young female with trochlear dysplasia. Speaker #5. Camille Azar. An elderly patient with end-stage patellofemoral arthrosis and satisfactory tibiofemoral joint. Speaker #6. Gilberto Camanho. A patient with complicated malalignment issues of trochlear dysplasia (A, B by Dejour) . Patellar movement and stress distribution in the cartilage on the lateral and medial facet is determined by coherent interaction of lateral and medial stabilizers, quadriceps femoris and own patellar ligament as well as patellar geometry and intercondylar groove In severe trochlear dysplasia (Dejour D), the point at the medial aspect of the cliff where the cartilage ended was chosen as the reference point for the medial height. The TDI was then calculated with the equation (a + b)/2, as depicted in Figure 2
Dejour trochlear dysplasia system (7). Exclusion criteria were as follows: Osteoarthritis, meniscus tears, metabolic bone disease, rheumatoid arthritis and a history of ipsilateral knee surgery. There were 19 males and 40 females in the patien The trochlear groove of the anterior distal femur guides the movement of the patella during knee flexion, Dejour et al developed a classification for deformity of the trochlea (trochlear dysplasia) seen on imaging studies 0 Trochlear Dysplasia patients report severe anxious mood (0%) 0 Trochlear Dysplasia patients report moderate anxious mood (0%) 0 Trochlear Dysplasia patients report mild anxious mood (0%) 0 Trochlear Dysplasia patients report no anxious mood (0%
Zurück zum Zitat Ntagiopolous PG, Dejour D (2014) Current concepts on trochleopalasty procedures for the surgical treatment of trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 22:2531-2539 CrossRef Ntagiopolous PG, Dejour D (2014) Current concepts on trochleopalasty procedures for the surgical treatment of trochlear dysplasia Brattstorm and Maldague [2, 3] gave the first classification of trochlear dysplasia using axial X-rays of the knee and Dejour H. et al. [4-8] gave the second classification based on the level of the trochlear line crossing with the lines of the two condyles, seen on profile X-rays Dejour et al. have described four morphologic types of trochlear dysplasia, and introduced a classification system, based on lateral radiographs and CT scans, which is widely used to assess the severity of the condition. The severity of trochlear dysplasia according to this classification is an indication for treatment (trochleoplasty) Lateral trochlear inclination (LTI) is the inclination angle between the femoral trochlea and a posterior condylar tangential line 1. Usage Lateral trochlear inclination (LTI) is used in the assessment of trochlear dysplasia, a dysplastic defor.. Lippacher S, Dejour D, Elsharkawi M, Dornacher D, Ring C, Dreyhaupt J, et al. Observer agreement on the Dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images. Am J Sports Med 2012;40 (04):837-84
Conclusions: Trochlear dysplasia is common in skeletally immature patients with patella instability. The assessment of trochlear dysplasia with axial imaging MRI is reliable and the objective measurements of TDI, LTI, and MCTO are more reproducible than the more subjective Dejour classification Dejour's classification is widely used to assess the severity of trochlear dysplasia. Additionally, in current literature, different quantitative parameters are recommended to distinguish between a normal trochlea and a dysplastic trochlea Background: Trochlear dysplasia appears in different geometrical variations. The Dejour classification is widely used to grade the severity of trochlear dysplasia and to decide on treatment. Purpose: To investigate the effect of trochlear dysplasia on patellofemoral biomechanics and to determine if different types of trochlear dysplasia have different effects on patellofemoral biomechanics The diagnosis and treatment of chronic patellar instability caused by trochlear dysplasia can be challenging. A dysplastic trochlea leads to biomechanical and kinematic changes that often require surgical correction when symptomatic. In the past, trochlear dysplasia was classified using the 4-part Dejour classification system. More recently, new classification systems have been proposed Trochlear dysplasia has according to Dejour et al  three radiographic features that are associated with a flat or even convex trochlea: the crossing sign (when the line of the trochlear groove crosses the highest point of the lateral trochlear facet), the double contour (when there is hypoplasia of the medial femoral condyle and the medial.
tern of trochlear dysplasia in adolescents. Methods: In a retrospective analysis, magnetic resonance images of adolescents with patellar instability and trochlear dysplasia were evaluated. These images were measured for lateral and medial condylar height, trochlear height, cartilaginous and bony trochlear bump, and cartilaginous and bony sulcus angle. The type of trochlear dysplasia was. email@example.com 1Lyon-Ortho-Clinic, Lyon, France 2 Mediterraneo Hospital, Hip & Knee Unit, Athens, Greece Received: 16.11.2014 Accepted: 20.12.2014 The surgical rationale and the operative technique of sulcus-deepening trochleoplasty for the treatment of recurrent patellar dislocation with severe trochlear dysplasia Trochlear dysplasia - its challenge in definition and its variable application in literature. A systematic review. Author(s): Tscholl P. (Switzerland) , Tscholl P. (Switzerland) Affiliations: Glanz L. , Glanz L..
Patellar instability, with repeated lateral dislocation, commonly seen in younger, active adults, is associated with a number of anatomical pathologies and usually requires surgical intervention. Among these, increased tibial tubercle to trochlear groove (TT-TG) distance is a prominent risk factor. TT-TG distance describes the degree of lateralization of the tibial tubercle Background: The risk factors for patellofemoral joint instability include laxity of medial patellar restraints, abnormal limb geometry, femoral and tibial malrotation, patella alta, and trochlear dysplasia. Femoral trochlear dysplasia is characterized by a hypoplastic or shallow trochlear groove. Case Report: We report the case of a 31-year-old female with trochlear dysplasia and recurrent.
Thin Flap Trochleoplasty Manfred Nelitz INTRODUCTION Pathogenesis Trochlear dysplasia is known to be a major risk factor for patellofemoral instability.1,2,3,4 Dejour et al5 found that 96% of patients with a history of a true patellar dislocation had evidence of trochlear dysplasia. In trochlear dysplasia, the trochlea is shallow, flat, or dome shaped mainly at it The type of trochlear dysplasia was classified as per Dejour classification. These measurements were plotted against age, and their growth patterns were evaluated using statistical methods. Results: Of 235 knees with patellar instability, trochlear dysplasia was present in 175 knees (74% knees) and these were further analyzed The Dejour classification was used to classify trochlear dysplasia. Dejour et al. (1990, 1994) classified trochlear dysplasia based on the trochlear angle and configuration. Dejour suggested the following morphological classification for trochlear dysplasia (Dejour et al. 1990). Type A: sulcus angle >145° but with normal shape (Fig. 2 VIDEO: Dejour says trochlear dysplasia should not be missed as factor for knee instability Science Daily Mar 17, 2017 Ligament reconstruction effective in treating kneecap instability from trochlear dysplasia: Study shows success even. Trochlear dysplasia is a developmental condition where the femoral trochlea loses its normal concave shape to an abnormal flat or even convex geometry [1, 2]. It has been identified as the most..