What is the trochlear groove of the knee?
Trochlear groove. The trochlear groove is the concave surface where the patella (kneecap) makes contact with the femur (thighbone). Also called the 'trochlea'. As the knee bends, the patella engages with the groove and is contained by its steep walls. Towards the top of the trochlear groove the walls are flatter.
What is dysplastic trochlear groove?
A shallow or dysplastic trochlear groove that develops in some people allows the patella to move too far side-to-side and may be a source of chronic patellar instability problems. The MPFL is a very important static stabilizer that helps prevent the patella from moving too far laterally out of the trochlear groove.
What is trochlear dysplasia and what causes it?
These 4 variations are associated with what is termed trochlear dysplasia, or an abnormal shape of this area of the knee. A shallow or dysplastic trochlear groove that develops in some people allows the patella to move too far side-to-side and may be a source of chronic patellar instability problems.
What is the difference between the lateral and medial trochlea?
The trochlea is composed of a medial and a lateral facet that forms the trochlear groove. The lateral facet is wider and more prominent. In the normal knee, the trochlear groove deepens more distally and deviates slightly lateral relative to the anatomical axis of the femur 61,62.
What does shallow trochlea mean?
The definition for trochlear dysplasia is an abnormal shallow, flat or even dome shaped groove. If you have trochlear dysplasia this can lead to both patella dislocation, anterior knee pain and cartilage breakdown. Your tendency to cartilage breakdown is based on too much load in this special part of the knee.
How do you fix shallow Trochlear groove?
Trochleoplasty involves either lengthening the walls of the trochlear groove or deepening the groove by removing bone or any abnormal bony growths. You may sometimes need additional surgical procedures such as ligament reconstruction to improve the outcome.
What is trochlea in the knee?
The trochlea is a groove in the femur bone underneath the kneecap (patella). The walls of the trochlea stabilize the patella and allow it to glide down the center of the trochlea as the knee bends.
What is a shallow femoral trochlea?
Femoral trochlear dysplasia is characterized by an abnormally shallow trochlear groove. Disengagement of the patella from the shallow femoral trochlea is common in FTD and is a predisposing risk factor to recurrent patellar dislocation and subsequent premature osteoarthrosis.
How many people have Trochlear dysplasia?
Knees with high-grade trochlear dysplasia based on the sulcus angle were 11 times more likely to have had previous patellar instability (p = 0.013). Conclusions: The prevalence of high-grade trochlear dysplasia in the general population is approximately 10%, and there may be an association with patellar instability.
Is Trochlear dysplasia painful?
Trochlear dysplasia also causes knee pain during activities that involve bending the knee such as walking up or down the stairs or running. In the long term, the abnormal movement of the patella on the femur can lead to the development of wear and tear of your joint surface known as osteoarthritis.
Is the trochlea a bone?
In the ocular orbit, trochlea is a fibrous cartilaginous pully like structure on the nasal aspect of the frontal bone through which superior oblique muscle passes.
Is walking good for arthritis in knees?
Walking is recommended for people with arthritis as it's low impact, helps to keep the joints flexible, helps bone health and reduces the risk of osteoporosis.
What is a trochlea in medical terms?
Medical Definition of trochlea : an anatomical structure resembling a pulley: as. a : the articular surface on the medial condyle of the humerus that articulates with the ulna. b : the fibrous ring in the inner upper part of the orbit through which the tendon of the superior oblique muscle of the eye passes.
Does Trochlear dysplasia require surgery?
In the early 1990's, researchers reported that up to 90% of patellofemoral instability is caused by trochlear dysplasia. Initially treatment consists of rest, use of crutches or braces, followed by physiotherapy. In cases where the patella instability is affecting patient's lifestyle, surgery is warranted.
How can I improve my knee tracking?
Nonsurgical treatment may include rest, regular stretching and strengthening exercises, taping or bracing the knee, using ice, and short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) . Quadriceps strengthening is the most commonly prescribed treatment for patellar tracking disorder.
Is Trochlear dysplasia genetic?
Although femoral trochlear dysplasia remains uncommon, the presence of bilateral recurrent patellar dislocation in multiple members of the same family is highly suggestive of genetic inheritance.
What does the Trochlear groove do?
In most knees, there is a groove on the end of the femur, called the trochlea, in which the kneecap sits. This provides a certain amount of bony stability to the kneecap joint to prevent it from sliding, mainly to the outside.
How can I improve my knee tracking?
Nonsurgical treatment may include rest, regular stretching and strengthening exercises, taping or bracing the knee, using ice, and short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) . Quadriceps strengthening is the most commonly prescribed treatment for patellar tracking disorder.
How do you fix knee dysplasia?
The only way to 'cure' it is to perform a patellofemoral resurfacing arthroplasty (a partial knee replacement), but this is a fairly major op that involves putting in an artificial joint, and this is normally reserved only for older patients and/or patients with severe symptoms and severe damage.
What is Trochleoplasty surgery?
A trochleoplasty is a surgical correction of the femoral trochlea to restore a normal or nearly normal entry of the patella into the trochlear groove during extension and flexion. Some general prerequisites are necessary to performing this procedure successfully.
What is the term for a deformity of the femoral trochlea?
Trochlear dysplasia. Trochlear dysplasia refers to a dysplastic deformity of the femoral trochlea and is a known risk factor for patellofemoral instability.
What is the prevalence of trochlear dysplasia?
The reported prevalence of trochlear dysplasia in recurrent patellar dislocations is ~80% (range 74-85%) 1,15. The latter is most common in the adolescent age group 4,5.
What is a known association with patellofemoral instability?
Trochlear dysplasia is a known association with patellofemoral instability.
What imaging method is used to diagnose trochlear dysplasia?
Different radiographic methods exist to assess for trochlear dysplasia in true lateral radiographic images of the knee and cross-sectional imaging CT and MRI respectively.
What is the bump in the distal femur?
trochlear bump: the increased distance between the anterior trochlear groove and extension of the anterior cortex of the distal femur
Is trochlear dysplasia a predisposing factor?
Trochlear dysplasia is a predisposing factor of patellofemoral instability and should be only treated in that context.
Is it worth getting both trochlear and radiographs?
Since cross-sectional images and radiographs show different aspects of trochlear dysplasia it might be worthwhile acquiring both if there are doubts with respect to the diagnosis ref.
Aspects of trochlear dysplasia
Trochlear dysplasia (TD) is an abnormality of the knees trochlear groove. There is an invisible transition between what is normal and what is pathologic. The knees trochlear groove is the guide channel, into which the patella engages and glides.
Heredity or origin or aetiology to TD
Larger apes have a flat trochlea 27, however, since humans are walking upright, we have become a little knock-kneed, as this brings the knee joints closer together and assists the upper body to be positioned above the centre of gravity for walking.
Closing remarks on TD
Another important point of issue is the trochlear difference of cartilage and bone configuration, also denominated cartilage/bone mismatch and that the cartilaginous sulcus angle is consistently higher than the underlying osseous sulcus due to thicker cartilage in the centre of the groove 13,62,65,66-68.
Why is the patella in the knee called the trochlear groove?
Normally, the patella glides smoothly and stays within what is called the trochlear groove as the knee flexes (bends) and extends (straightens). An unstable kneecap comes either completely or partially out of the groove as the knee bends.
Why is the patella pulled toward the outside of the knee?
Because of the Q angle, the patella has a tendency to be pulled toward the outside (lateral portion) of the knee when the quadriceps muscles contract (tighten). This is where the shape, height, and slope of the trochlear groove is important to help keep the patella in its proper position.
What is patellar stability?
Patellar stability, defined as the condition in which the kneecap glides normally and stays within the trochlear groove as the knee flexes and extends, is influenced by several factors: Angle of Knee Flexion and Dynamic Stabilizers.
How common is patellar dislocation?
Acute patellar dislocation is a common traumatic knee injury in individuals 10-19 years of age. One study reported that approximately 43 per 100,000 children aged 16 years or younger sustained this injury.
Where does a patellar dislocation occur?
Nearly all patellar dislocations occur in the lateral direction, meaning the patella slides out of the groove toward the outside of the knee. The patella may return to the normal position on its own (called a spontaneous reduction), or the patient or a medical professional may have to relocate it back into place.
Which muscle pulls the patella toward the inside of the knee?
The vastus medialis oblique (VMO) muscle pulls the patella toward the inside (medial) of the knee joint. The MPFL acts as a check-rein to resist a patella dislocation toward the outside (lateral) portion of the knee joint.
When to replace patellofemoral joint?
Replacing just the patellofemoral joint is a valid treatment option, especially in patients 40-50 years of age (and sometimes younger) if other operations have failed to alleviate their kneecap pain and the medial and lateral compartments of the knee are not damaged.
Which part of the trochlear groove is flatter?
Towards the top of the trochlear groove the walls are flatter. When the knee is in extension (straight) and the patella in the upper part of the groove, it is more easily able to disengage (sublux).
What is the groove on the femur called?
Trochlear groove. The trochlear groove is the concave surface where the patella (kneecap) makes contact with the femur ( thighbone ). Also called the ' trochlea '. As the knee bends, the patella engages with the groove and is contained by its steep walls. Towards the top of the trochlear groove the walls are flatter.
