Trochlear depth (TD) measures the depth of the trochlear groove in relation to the femoral condyles.
A review of the quality assessment of measurements for trochlear dysplasia identified trochlear depth (TD) as one of the more useful measurements 3.
On a true lateral radiograph of the knee, a line at an angle of 15° from a cutting point of a tangent to the posterior femoral diaphyseal cortex and a perpendicular running tangent of the most proximal part of the femoral condyle is used to measure trochlear depth as the distance between the trochlear groove and the lateral femoral facet 1,3.
Different methods exist. The method introduced by Pfirrmann measures the distance of the trochlear groove and the medial and lateral trochlear facets to a tangential line of both femoral condyles. In order to calculate trochlear depth the distance from the trochlear groove from the before mentioned tangent is subtracted from the average of the two distances between the medial and lateral facet and that tangent 2. The measurement was conducted at different levels above the knee joint and found most useful at 3 cm at the joint line 2.
A simpler technique described later just measures the distance between the trochlear floor and a tangential line connecting the most anterior points of the medial and lateral facet 4,5.
A threshold value of ≤4 mm was considered pathological in view of Henri Dejour.
A trochlear depth of ≤3 mm with Pfirrmann’s method resulted in a sensitivity and specificity of 100% and 96% in that study 2.
History and etymology
The measurement of trochlear depth on the lateral radiograph was described by Henri Dejour 1.
The first trochlear depth measurement on MRI was introduced by CW Pfirrmann 2.
- 1. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. (1994) Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2 (1): 19-26. doi:10.1007/BF01552649 - Pubmed
- 2. Pfirrmann CW, Zanetti M, Romero J, Hodler J. Femoral trochlear dysplasia: MR findings. (2000) Radiology. 216 (3): 858-64. doi:10.1148/radiology.216.3.r00se38858 - Pubmed
- 3. Paiva M, Blønd L, Hölmich P, Steensen RN, Diederichs G, Feller JA, Barfod KW. Quality assessment of radiological measurements of trochlear dysplasia; a literature review. (2018) Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 26 (3): 746-755. doi:10.1007/s00167-017-4520-z - Pubmed
- 4. Ali SA, Helmer R, Terk MR. Analysis of the patellofemoral region on MRI: association of abnormal trochlear morphology with severe cartilage defects. (2010) AJR. American journal of roentgenology. 194 (3): 721-7. doi:10.2214/AJR.09.3008 - Pubmed
- 5. Charles MD, Haloman S, Chen L, Ward SR, Fithian D, Afra R. Magnetic resonance imaging-based topographical differences between control and recurrent patellofemoral instability patients. (2013) The American journal of sports medicine. 41 (2): 374-84. doi:10.1177/0363546512472441 - Pubmed