The shape and orientation of the trochlea run more parallel to the posterior condylar line than generally believed

Purpose This study was set up to identify the native trochlear geometry and define its relationship with the rotational landmarks of the distal femur. Methods The rotational landmarks of the distal femur were analysed on CT-scans of 281 patients with end-stage knee osteoarthritis. Results The anteri...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2018-09, Vol.26 (9), p.2685-2691
Main Authors: Vercruysse, C., Vandenneucker, H., Bellemans, J., Scheys, L., Luyckx, T.
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Knee
Biocompatibility
Biomedical materials
Computed tomography
Female
Femoral components
Femur
Femur - anatomy & histology
Femur - diagnostic imaging
Femur - pathology
Femur - surgery
Humans
Knee
Knee Joint - anatomy & histology
Knee Joint - diagnostic imaging
Knee Joint - pathology
Knee Joint - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Osteoarthritis
Osteoarthritis, Knee - diagnostic imaging
Osteoarthritis, Knee - pathology
Osteoarthritis, Knee - surgery
Preoperative Care
Rotation
Surgery
Tomography, X-Ray Computed
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Summary:Purpose This study was set up to identify the native trochlear geometry and define its relationship with the rotational landmarks of the distal femur. Methods The rotational landmarks of the distal femur were analysed on CT-scans of 281 patients with end-stage knee osteoarthritis. Results The anterior trochlear line (ATL) was on average 4.3° (SD 3.3°) internally rotated relative to the surgical transepicondylar axis (sTEA). The ATL was on average 2.1° (SD 3.0°) internally rotated relative to the posterior condylar line (PCL). The relationship between the ATL and the sTEA was statistically different in the different coronal alignment groups ( p  = 0.004): 3.9° (SD 3.0°) in varus knees, 4.0° (SD 2.9°) in neutral knees and 5.4° (SD 3.8°) in valgus knees. The lateralisation of the trochlea, represented by the distance between the perpendicular to PCL and the perpendicular to the posterior parallel line to the sTEA, was on average 2.2 mm (SD 1.8 mm). Conclusion The ATL was on average 4.3° (SD 3.3°) internally rotated relative to the sTEA and 2.1° (SD 3.0°) internally rotated relative to the PCL. The ATL is more externally orientated in varus knees and more internally rotated in valgus knees. The trochlear groove is lateralised by only 2.2 mm when the femoral component is externally rotated. Level of evidence III.
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-017-4685-5