Femoral Trochlea Morphology: A Gender and Bilateral Comparative Study Using MRI

Öz

Objective: The sulcus angle and trochlear depth have been widely used in the literature as a measure of trochlear morphology. The purpose of our study was to assess gender-based anatomical differences of the femoral trochlea using magnetic resonance imaging (MRI).

Materials and Methods: A total of 100 patients (50 women, 50 men) were included in our study. All patients had both their knees analyzed; trochlear morphology was measured using trochlear depth, and the femoral sulcus angle on axial MR images.

Results: The mean trochlear depths in the men and women were 9.1 ± 1.5 mm and 6.9 ± 1.4 mm, and the mean femoral sulcus angles in the men and women were 127 ± 9.3° and 134.7 ± 8.6°, respectively. Using MRI, no statistically significant differences were found between the right and left knees.

Conclusion: This study demonstrates significant gender differences in trochlear morphology. The trochlear groove is significantly less deep and shallower amongst women than in men.

Anahtar Kelimeler

• trochlea,sulcus angle,magnetic resonance imaging

Femoral Troklear Morfoloji: MRG ile Cinsiyet ve Bilateral Karşılaştırmalı Çalışma

Öz

Amaç :  Literatürde troklear morfolojiyi  ölçmede sulkus açısı ve troklear derinlik yaygın olarak kullanılmaktadır. Bu çalışmada amacımız magnetik rezonans görüntüleme  (MRG ) kullanılarak  femoral trokleada cinsiyet temelli anatomik farklılıkları saptamaktır.

Gereç ve Yöntemler: Çalışmaya toplamda 100 hasta ( 50 kadın, 50 erkek ) dahil edildi. Tüm hastalarda her iki dizde  aksiyal  MR görüntülerinde femoral sulkus açısı ve troklear derinlik kullanılarak troklear morfoloji analiz edildi.

Bulgular: Ortalama troklear derinlik erkeklerde  9.1 ± 1.5 mm , kadınlarda ise 6.9 ± 1.4 mm  ve ortalama femoral sulkus açısı erkeklerde 127 ± 9.3 °  ve kadınlarda 134.7 ± 8.6 ° idi. MRG de sağ ve sol diz arasında istatistiksel olarak anlamlı fark saptanmadı.

Sonuç: Bu çalışma troklear morfolojide cinsiyetler arasında fark olduğunu tanımladı. Troklear groove   kadınlarda erkeklerden daha sığ ve geniştir.

Anahtar Kelimeler

• troklea,sulkus açısı,manyetik rezonans görüntüleme

Kaynakça

1. 1. Stefanik JJ, Roemer FW, Zumwalt AC, Zhu Y, Gross KD, Lynch JA et al. Association between measures of trochlear morphology and structural features of patellofemoral joint osteoarthritis on MRI: the MOST study . J Orthop Res 2012 ;30 :1-8.
2. 2.Botchu R, Obaid H, Rennie WJ. Correlation between trochlear dysplasia and the notch index . J Orthop Surg 2013;21:290-3. 3. Teichtahl AJ, Parkins K, Hanna F, Wluka AE, Urquhart DM, English DR et al. The relationship between the angle of the trochlear groove and patella cartilage and bone morphology--a cross-sectional study of healthy adults. Osteoarthritis Cartilage 2007 ;15:1158-62.
3. 4. Murshed KA, Cicekcibası AE, Ziylan T, Karabacakoglu A. Femoral sulcus angle measurements: Anatomical study of magnetic resonance images and dry bones. Turk J Med Sci 2004;34:154-169.
4. 5. Tecklenburg K, Dejour D, Hoser C, Fink C. Bony and cartilaginous anatomy of the patellofemoral joint . Knee Surg Sports Traumatol Arthrosc 2006 ;14:235-40.
5. 6. Ali SA, Helmer R, Terk MR. Analysis of the patellofemoral region on MRI: association of abnormal trochlear morphology with severe cartilage defects. AJR Am J Roentgenol 2010 ;194:721-7.
6. 7. Pfirrmann CW, Zanetti M, Romero J, Hodler J. Femoral trochlear dysplasia: MR findings. Radiology 2000 ;216:858-64.
7. 8. Endo Y, Schweitzer ME, Bordalo-Rodrigues M, Rokito AS, Babb JS. MRI quantitative morphologic analysis of patellofemoral region: lack of correlation with chondromalacia patellae at surgery . AJR Am J Roentgenol 2007 ;189:1165-8.
8. 9. Mehl J, Feucht MJ, Bode G, Dovi-Akue D, Südkamp NP, Niemeyer P . Association between patellar cartilage defects and patellofemoral geometry: a matched-pair MRI comparison of patients with and without isolated patellar cartilage defects . Knee Surg Sports Traumatol Arthrosc 2016; 24:838-46.

9. 10. McNally EG, Ostlere SJ, Pal C, Phillips A, Reid H, Dodd C . Assessment of patellar maltracking using combined static and dynamic MRI. Eur Radiol 2000;10:1051-5.
10. 11.Kim YM, Joo YB. Patellofemoral osteoarthritis. Knee Surg Relat Res 2012;24:193-200.
11. 12. Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 1974;56:1391-1396.
12. 13. Alemparte J, Ekdahl M, Burnier L, Hernández R, Cardemil A, Cielo R et al. Patellofemoral evaluation with radiographs and computed tomography scans in 60 knees of asymptomatic subjects. Arthroscopy 2007 ;23:170-7.
13. 14. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 1994;2:19-26.
14. 15.Haster RM, Gal I, Biedert RM. Landmarks of the normal adult human trochlea based on axial MRI measurements: a cross-sectional study. Knee Surg Sports Traumatol Arthrosc 2014;22:2372-2376.
15. 16. Stäubli HU, Dürrenmatt U, Porcellini B, Rauschning W. Anatomy and surface geometry of the patellofemoral joint in the axial plane . J Bone Joint Surg Br 1999 ;81 :452-8.
16. 17. Shih YF, Bull AM, Amis AA. The cartilaginous and osseous geometry of the femoral trochlear groove. Knee Surg Sports Traumatol Arthrosc 2004 ;12:300-6.
17. 18.Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med 2010;26:355-369.
18. 19.Tsavalas N, Katonis P,Karantanas AH.Knee joint anterior malalignment and patellofemoral osteoarthritis : an MRI study. Eur Radiol 2012;22:418-428.
19. 20.Ali SA, Helmer R, Terk MR. Analysis of patellofemoal region on MRI : association of abnormal trochlear morphology with severe cartilage defect . AJR Am J Roentgenol 2010;194:721-727.
20. 21. Salzmann GM, Weber TS, Spang JT, Imhoff AB, Schöttle PB. Comparison of native axial radiographs with axial MR imaging for determination of the trochlear morphology in patients with trochlear dysplasia. Arch Orthop Trauma Surg 2010;130:335-40.