ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Adapting the Dejour classification of trochlear dysplasia from qualitative radiograph- and CT-based assessments to quantitative MRI-based measurements.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Knee morphology and patella malalignment in neglected developmental dysplasia of the hip: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Patellofemoral instability: Anatomy, imaging techniques, and clinically relevant measurements.Skeletal radiology · 2026Review
- A Multiplanar Reformatting Technique to Correct for Scanner Misalignment During Computed Tomography Measurement of Tibial Tuberosity-Trochlear Groove Distance.Arthroscopy techniques · 2026Article
- Lower Trochlear Facet Asymmetry Ratio Is Associated with Objective Patellar Instability in a Retrospective MRI Case-Control Study with Patella Alta-Positive Controls.Journal of clinical medicine · 2026Article
- Increased sagittal patellar height and reduced trochlear engagement on MRI are associated with recurrent patellar instability in skeletally immature knees: A comparative study.Journal of experimental orthopaedics · 2026Article
- Open Lateral Retinacular Lengthening During an "À La Carte" Step-by-Step Surgical Approach for Habitual Patellar Dislocation.Arthroscopy techniques · 2026Article
- Assessing Trochlear Dysplasia With the Novel Lateral Trochlear Anterior Condyles Angle.Orthopaedic journal of sports medicine · 2026Article
- Rotation matters: CT and MRI yield different tibiofemoral rotation angles in patellofemoral patients. An investigational plateau-anchored MRI method is descriptively associated with a smaller mean CT-MRI difference.Journal of experimental orthopaedics · 2026Article
- Mapping the Femoral Trochlea: Development of the Multi-level Axial Patellofemoral Score for Trochlear Dysplasia (MAPS-TD) to Classify Trochlear Dysplasia Severity.Orthopaedic journal of sports medicine · 2026Article
- Patellar Morphology in Recurrent Lateral Patellofemoral Instability: Associations With Risk Factors and Postoperative Outcomes.Orthopaedic journal of sports medicine · 2026Article
- A retrospective Follow-Up after derotational distal femoral osteotomy combined with medial patellofemoral ligament reconstruction for the treatment of recurrent patellar dislocation.Journal of orthopaedic surgery and research · 2026Article
- Elucidate the quantitative early diagnostic indicators of mild chondromalacia patella: ratios of trochlear sulcus angle to patellar and trochlear widths.Frontiers in medicine · 2026Article
- Excellent Intra- and Interobserver Reliability of the D.H. Dejour Version 2 Classification for Trochlear Dysplasia Using Radiographs Combined With MRI With Evaluation of Shortcomings.Orthopaedic journal of sports medicine · 2026Article
- The Impact of Axial CT Level Selection on Grading Trochlear Dysplasia Using Dejour Classification.Diagnostics (Basel, Switzerland) · 2025Article
- Artificial Intelligence for the Diagnosis and Management of Patellofemoral Instability: A Comprehensive Review.Diagnostics (Basel, Switzerland) · 2025Review
- Evaluating the performance of five large language models in answering Delphi consensus questions relating to patellar instability and medial patellofemoral ligament reconstruction.BMC musculoskeletal disorders · 2025Article
- Predisposing Anatomical Patellofemoral Factors for Subsequent Patellar Dislocation.Life (Basel, Switzerland) · 2025Article
- Adapting the Dejour classification of trochlear dysplasia from qualitative radiograph- and CT-based assessments to quantitative MRI-based measurements.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Patellar instability: current approach.EFORT open reviews · 2025Article
- Tibial Tuberosity-Trochlear Groove Ratio Adjusts for Sex Differences and Improves Accuracy in Assessing Patellofemoral Instability.Orthopaedic journal of sports medicine · 2025Article
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Authors and funding
8 authors.
Funding
Abstract
purposeTo adapt the current D. Dejour trochlear dysplasia classification (v2.0) to only rely on quantitative magnetic resonance imaging (MRI) measurements (v3.0) to maximize objectivity and repeatability.
methodsA consecutive series of adult knee MRIs were divided into objective patellar instability (OPI, n = 127) or controls (n = 103; isolated meniscal tears) and postprocessed with multiplanar reconstruction (MPR) to standardize the sagittal plane and ensure true lateral views. Thresholds for sulcus angle, lateral trochlear inclination (LTI) and central bump were established using regression tree models to distinguish OPI from controls. The sensitivity and specificity of sulcus angle and LTI combinations to diagnose OPI were then evaluated, and the combination yielding the highest sensitivity was selected as basis for trochlear dysplasia classification. Finally, sulcus angle and LTI measurability and presence of a central bump >5 mm were used to grade dysplasia as low, moderate or high.
resultsThe regression tree models produced thresholds of ≥157° for sulcus angle and <14° for LTI to distinguish OPI from controls. 'Sulcus angle ≥157° OR LTI < 14°' yielded the highest sensitivity (87%) to diagnose OPI. The quantitative MRI classification was sulcus angle <157° AND LTI ≥ 14° for Type 0 (No dysplasia); (sulcus angle ≥ 157° OR LTI < 14°) AND central bump <5 mm for Type 1 (Low-grade dysplasia); (sulcus angle OR LTI are 'unmeasurable') AND central bump <5 mm for Type 2 (Moderate-grade dysplasia); (sulcus angle ≥ 157° OR 'unmeasurable' OR LTI < 14° OR 'unmeasurable') AND central bump ≥5 mm for Type 3 (High-grade dysplasia).
conclusionThis MRI classification depends exclusively on quantitative measurements, has excellent interobserver agreement, and yields high sensitivity to diagnose OPI. The MRI imaging protocol with MPR mode and standardized measurements could be quickly adopted and correctly applied by clinicians worldwide in any type of institution to determine the ideal treatment plan. LEVEL OF EVIDENCE: Level III.
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