ArticleOrthopaedic surgery2026
Trochlear Morphological Parameters Based on Measurements at the Trochlear Groove Entry Plane Demonstrate Excellent Predictive Efficacy for Identifying the High-Grade J-Sign.
Article in Orthopaedic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe correction of high-grade J-sign is critical for improving clinical outcomes in patients with trochlear dysplasia, but insufficient attention has been given to anatomical abnormalities at the trochlear groove entry plane, the established gold standard for describing trochlear morphology. We aim to compare the diagnostic accuracy and reliability of axial computed tomography (CT) measurements at the trochlear groove entry plane versus the Roman arch plane in predicting the J-sign among patients with patellar instability.
methodsThis retrospective study enrolled 120 knees diagnosed with recurrent patellar dislocation. Based on patellar tracking assessments, the J-sign was categorized into a low-grade group (J-sign negative and Grade I) and a high-grade group (J-sign Grades II and III). Preoperative measurements of trochlear depth, sulcus angle (SA), and lateral trochlear inclination (LTI) were obtained at both the trochlear groove entry plane and Roman arch plane using computed tomography (CT). Receiver operating characteristic (ROC) curve analysis was utilized to evaluate the predictive accuracy of the three parameters measured at both anatomical planes for J-sign severity.
resultsParameters measured at the trochlear groove entry plane demonstrated superior diagnostic accuracy on ROC curves compared with those obtained at the Roman arch plane. In both planes, the trochlear depth and LTI of the high-grade group were significantly lower than that of the low-grade group, while the SA was significantly higher than that of the low-grade group (all p < 0.01). At the trochlear groove entry plane, the area under the curve (AUC) values for distinguishing low-grade and high-grade J-sign were as follows: AUC
conclusionsWhen evaluating knee parameters in patients with recurrent patellar instability, axial CT measurements at the trochlear groove entry plane demonstrate superior predictive efficacy for the J-sign compared to the Roman arch plane. Specifically, CT-based measurement of the SA enables enhanced differentiation between low-grade and high-grade J-sign subgroups, providing critical preoperative insights of patellar maltracking.
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