Distal Femoral Torsion is Correlated with Higher-grade Trochlear Dysplasia and Shorter Anterior Condyles in Patients with Patellar Dislocation and Increased Femoral Torsion

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2023 Oct 25

PMID 37878013

Authors

Kuo Hao

Yingzhen Niu

Zhenhui Huo

Fei Wang

Affiliations

Soon will be listed here.

Abstract

Purpose: To describe the characteristics of femoral torsion in patients with different segmental torsion types and to evaluate the correlations between segmental torsion and the morphology of the femoral condyles and trochlea in patients with patellar dislocation and increased femoral torsion.

Methods: Between January 2021 and March 2023, 69 patients were included and classified into two groups according to the femoral segment contributing the most to total torsion: 32 patients in Group A (femoral neck and shaft torsion) and 37 patients in Group B (distal torsion). Trochlear dysplasia was evaluated using Dejour's classification and sulcus angle. The morphology of the femoral condyles was evaluated using the lengths and ratios of the medial and lateral condyles. Correlations between femoral torsion and morphology were evaluated.

Results: Total torsion was significantly correlated with femoral neck and shaft torsion (r = 0.882, P < 0.001) and distal torsion (r = 0.262, P = 0.030). Femoral neck and shaft torsion was significantly increased with increasing total torsion. The trochlear sulcus was flatter and more dysplastic, and the anterior condyles were shorter in Group B. Distal torsion was significantly correlated with the lengths of the medial and lateral anterior condyles (r = - 0.567, P < 0.001; r = -0.701, P < 0.001), sulcus angle (r = 0.611, P < 0.001) and Dejour trochlea type (r = 0.512, P = 0.001), while femoral neck and shaft torsion showed no correlations.

Conclusion: Femoral torsion is a complex of femoral neck and shaft torsion and distal torsion, especially femoral neck and shaft torsion. Distal torsion was significantly correlated with a flatter trochlear sulcus, higher-grade trochlear dysplasia, and shorter anterior condyles. The new findings highlighted the importance of the segmental evaluation of femoral torsion, which would facilitate understanding of the anatomical characteristics of femoral torsion in patients with patellar dislocation and increased femoral torsion and may lead to improvement in the surgical options regarding femoral torsion.

Level Of Evidence: Level III.

Citing Articles

Derotational distal femoral osteotomy yields better outcomes in patellar subluxation with proximal femoral torsion compared with distal femoral torsion: A retrospective comparative study.

Jia Y, Bao H, Hou J, Sun R, Wang Z, Jiang J J Orthop Surg Res. 2024; 19(1):640.

PMID: 39380005 PMC: 11462965. DOI: 10.1186/s13018-024-05123-x.

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