Relationship of trochlear femur facet asymmetry wi̇th patellofemoral instability

Purpose: Patellofemoral instability is topic on which there is still no consensus regarding diagnosis and treatment. There are not enough studies in the literature evaluating the effect of trochlear femur facet asymmetry on patellofemoral instability, and therefore this thesis study was conducted. This study was conducted to investigate the relationship between trochlear femur facet asymmetry and patellofermoral instability and, if there is a significant relationship, to compare this relationship with other major risk factors and contribute to the creation of diagnostic and treatment algorithms. Patients and Methods: According to the definition of objective patellar instability described by Dejour, patients with objective patellar instability, a history of at least one patellofemoral dislocation, and patients with patella alta on plain radiographs were identified as patients without objective patellar instability. Then, we examined the knee images of these patients taken with magnetic resonance devices with a 1.5 Tesla feature. In this magnetic resonance imaging, we determined trochlear facet asymmetry, trochlear dysplasia, Tuberositas Tibia-Trochlear Groove distance, patellar axial engagement index, and Wiberg patellar morphology types. To evaluate the relationships between these parameters, we created two groups with and without objective patellar instability. The study group consisted of 43 patients in total, including 26 women and 17 men, and the control group consisted of 43 patients in total, including 24 women and 19 men. Our study is a retrospective study. In this study, we performed the magnetic resonance imaging measurements of both groups with the Picture Archiving and Communication Systems (PACS) v4.1.2.22 program in our hospital system. Results: In the statistical analysis of the two groups, we divided them into those with and without objective patellar instability; no significant difference was found between age, gender, side, or body height. In the group with patellofemoral instability, the Tuberositas Tibia-Trochlear Groove distance and Wiberg value were significantly (p<0,05) higher than the group without patellofemoral instability. Facet asymmetry, trochlear dysplasia, and axial engagement index values in the group with patellofemoral instability were significantly (p<0,05) lower than the group without patellofemoral instability. In the univariate model, a significant (p<0,05) effectiveness of Tuberositas Tibia-Trochlear Groove distance, trochlear dysplasia, trochlear facet asymmetry, axial engagement index, and Wiberg value was observed in distinguishing patients with and without patellofemoral instability; however, no significant (p>0,05) effect of 4 the age value was observed. In the multivariate model, significant-independent (p<0,05) effectiveness of trochlear facet asymmetry, axial engagement index, and Wiberg value was observed in distinguishing patients with and without patellofemoral instability. Conclusion: In our study, trochlear facet asymmetry was determined to be a parameter associated with patellofemoral instability, and among other major risk factors, trochlear facet asymmetry was found to be the parameter most associated with patellofemoral instability. In addition, in this study, the relationship between trochlear and patellar morphology was also examined, and a significant relationship was detected between them.