Patients with trochlear dysplasia may have posteriorly positioned femoral tunnel

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Key takeaways:

  • Patients with patellar instability and dysplasia have radiographic landmarks positioned more than 3 mm posteriorly vs. normal knees.
  • These radiographic landmarks are important to identify the femoral tunnel.

BOSTON — In this video from the Arthroscopy Association of North America Annual Meeting, Miho J. Tanaka, MD, PhD, discussed radiographic positioning of the femoral tunnel in surgical candidates with patellar instability and dysplasia.

“Femoral tunnel positioning is critical in [medial patellofemoral complex] reconstruction to avoid complications,” Tanaka told Healio.

Tanaka and colleagues performed a study that analyzed radiographic landmarks of patients with trochlear dysplasia and required surgery for patellar instability. They found knees with dysplasia had landmarks that were at least 3 mm posterior compared with normal knees.

“These are important findings because we often use radiographic landmarks and especially Schöttle’s Point, which is commonly cited in order to identify the femoral tunnel,” Tanaka said. “I think we should be considering that when we perform this procedure on patients with patellar instability, and especially with trochlear dysplasia, that we should be considering moving those landmarks and that femoral tunnel positioning more posteriorly.”

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