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Does form follow function in trochlear dysplasia? Case report of patellar instability in a below-knee amputee.

Salzmann GM, Dovi-Akue D, Wätzig K, Südkamp NP, Niemeyer P - Int J Surg Case Rep (2013)

Bottom Line: One major static compound is found to be in trochlear dysplasia.Against this assumption, we hypothesize that subjects may devise a flattened trochlea when there is no significant biomechanical interplay and thus input between the patella and the distal femur during developmental growth; according to the assumption form follows function.One has to consider that a certain biomechanical input may be required for the development of a physiologic trochlear groove.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany. Electronic address: giansalzmann@yahoo.com.

No MeSH data available.


Related in: MedlinePlus

Preoperative conventional weight-bearing and AP hip-knee-ankle radiographs. Manually drawn Mikulicz line displaying the mechanical axis depicts minimal valgus at right leg (left on image) and slight varus deformity at left leg. Right lower extremity replaced by prosthesis.
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fig0010: Preoperative conventional weight-bearing and AP hip-knee-ankle radiographs. Manually drawn Mikulicz line displaying the mechanical axis depicts minimal valgus at right leg (left on image) and slight varus deformity at left leg. Right lower extremity replaced by prosthesis.

Mentions: Radiographic examination identified a straight leg axis (Fig. 2), while the Patella skyline view at 30°, 60° and 90° of flexion revealed a flattened trochlea and a flattened patellar undersurface when compared with the left knee joint (Fig. 3). We made this observation even though being familiar with previous data presented on limitations of plain radiographic examination of the trochlea.10 Insall-Salvati was 1.42 in display of patella alta. Standard MRI clearly showed a high-grade trochlear dysplasia type C according to Dejour2 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 of 4.7 mm with an Insall-Salvati of 1.35.


Does form follow function in trochlear dysplasia? Case report of patellar instability in a below-knee amputee.

Salzmann GM, Dovi-Akue D, Wätzig K, Südkamp NP, Niemeyer P - Int J Surg Case Rep (2013)

Preoperative conventional weight-bearing and AP hip-knee-ankle radiographs. Manually drawn Mikulicz line displaying the mechanical axis depicts minimal valgus at right leg (left on image) and slight varus deformity at left leg. Right lower extremity replaced by prosthesis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921661&req=5

fig0010: Preoperative conventional weight-bearing and AP hip-knee-ankle radiographs. Manually drawn Mikulicz line displaying the mechanical axis depicts minimal valgus at right leg (left on image) and slight varus deformity at left leg. Right lower extremity replaced by prosthesis.
Mentions: Radiographic examination identified a straight leg axis (Fig. 2), while the Patella skyline view at 30°, 60° and 90° of flexion revealed a flattened trochlea and a flattened patellar undersurface when compared with the left knee joint (Fig. 3). We made this observation even though being familiar with previous data presented on limitations of plain radiographic examination of the trochlea.10 Insall-Salvati was 1.42 in display of patella alta. Standard MRI clearly showed a high-grade trochlear dysplasia type C according to Dejour2 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 of 4.7 mm with an Insall-Salvati of 1.35.

Bottom Line: One major static compound is found to be in trochlear dysplasia.Against this assumption, we hypothesize that subjects may devise a flattened trochlea when there is no significant biomechanical interplay and thus input between the patella and the distal femur during developmental growth; according to the assumption form follows function.One has to consider that a certain biomechanical input may be required for the development of a physiologic trochlear groove.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany. Electronic address: giansalzmann@yahoo.com.

No MeSH data available.


Related in: MedlinePlus