M. Mologne (Vail, US)
Steadman Philippon Research InstitutePresenter Of 2 Presentations
10.1.2 - Increased MFC Width and Osteochondritis Dissecans: Cause or Effect and Implications for Osteochondral Allograft Transplantation
Abstract
Purpose
Evaluate the relationship between MFC width and osteochondritis dissecans and assess whether increased MFC width is a cause or effect of OCD.
Methods and Materials
MRIs of 112 patients with osteochondritis dissecans of the MFC and age and gender matched control MRIs were reviewed. MFC width and tibial plateau width were recorded. T-test statistic was used to compare OCD patients with controls. Data was also assessed to determine effects of age and gender.
Results
The mean MFC width in OCD patients was 29.2 mm, which was statistically greater than controls ( p<0.001 ). Age did not have any statistical effect on MFC width in OCD patients. Men had wider MFCs as compared to women in all age groups in OCD patients and controls. Tibial plateau width did not differ between OCD patients and controls when matched by gender. Age had no effect on tibial plateau width.
Conclusion
The MFC is wider than normal in patients wtih osteochondritis dissecans of the MFC. Wider MFCs are seen even in young OCD patients, suggesting that it may play a role in the development of OCD. When considering an osteochondral allograft transplant, surgeons must keep in mind that 29 mm wide MFCs are very uncommon and if size matching is desired, other graft options like LFCs should be considered.
10.3.9 - Trochlear Morphology in Healthy People: Implications for Osteochondral Allograft Transplantation
Abstract
Purpose
The purpose of this study was: 1) to assess trochlear width, depth, and sulcus angle via magnetic resonance imaging (MRI) in patients without patellofemoral problems and 2) to determine whether bench measurements of donor femurs can better match donors and patients.
Methods and Materials
An analysis was performed on 209 deidentified MRIs. Trochlear width and depth were measured 15 mm and 20 mm distal to the most proximal articular surface. MRI’s were classified into three groups based on trochlear depth (Group 1: 0-4.0 mm; Group 2: 4.1-6.0 mm; 16 Group 3: > 6.0 mm). Difference in trochlear depth at the two distances was calculated. The same protocol was performed on 23 cadaveric knees.
Results
209 MRIs (ages 12-57, average age: 25.8 years) were included in the review. Mean trochlear depths at 15mm and 20mm were significantly different between the groups. Group 3 had significantly larger trochlear widths than Groups 1 and 2. All MRIs showed an increase in trochlear depth between 15 and 20 mm (mean increase: 1.31 ± 0.78 mm). There was no significant difference in trochlear depths between MRI and cadaveric groups. For MRI groups at 15 mm, the resultant apex decreased 10° between Groups 1 and 2 and decreased 7.4° between Groups 2 and 3.
| Group 1 | Group 2 | Group 3 | |
| Trochlear Width | 36.25 mm | 37.50 mm | 39.00 mm |
| Trochlear Depth | 3.35 mm | 5.21 mm | 6.80 mm |
| Apex (Sulcus Angles) | 159 degrees | 149 degrees | 141.6 degrees |
Conclusion
Tibial width has historically been used to assess OCA transplantation but does not consider trochlear depth nor does it guarantee suitable pairings. Assuming trochleae are perfect isosceles triangles, one can measure trochlear width and cartilage sulcus angle via MRI to assess trochlear depth. Additionally, trochlear data was distributed into three independent groups. Consideration of trochlear depth and its distribution may enable more accurate OCA matching.
