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2019_Rezvanifar_Dissertation.pdf (9.18 MB)

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Computational Analysis and Anatomical Characterization of Trochlear Dysplasia in Patellar Instability

Rezvanifar, Sayed Cyrus
http://rave.ohiolink.edu/etdc/view?acc_num=akron1571224864867381

Abstract Details

2019, Doctor of Philosophy, University of Akron, Biomedical Engineering.
Patellar instability is a pathological condition that accounts for 16% to 25% of all injuries in runners and affects young athletes, particularly those with characteristic knee anatomical abnormalities. Trochlear dysplasia which refers to any geometrical abnormality in the femoral trochlear groove—also known as intercondylar groove—is among the main anatomical factors leading to patellar instability, and has been noted in more than 90% of patients with episodic patellar dislocations. Medial patellofemoral ligament (MPFL) is the main passive restraint against patellar lateral maltracking and is typically injured during an instability episode. Hence, MPFL reconstruction has been increasingly considered as the main surgical stabilization technique following patellar dislocation. In spite of the favorable clinical outcomes of MPFL reconstruction, neglecting patient-specific anatomical features can affect the efficacy of this surgical intervention and lead to complications such as recurring dislocation episodes. This study investigates the hypothesis that the efficacy of MPFL reconstruction in eliminating the risks of lateral patellar maltracking is affected by the severity of trochlear dysplasia. Imaging data from patients being surgically treated for patellar instability were collected to construct three-dimensional (3D) computational knee joint models. The created models were imported into a multibody dynamic simulation platform to simulate knee extension and squatting motions. In order to study the effects of anatomical factors––particularly trochlear dysplasia—on patellar instability, an automated algorithm was developed to systematically alter the depth of trochlear groove and characterize trochlear dysplasia with respect to patellofemoral kinematics. The models were thereafter utilized to evaluate the efficacy of MPFL reconstruction in effectively limiting patellar maltracking in existence of trochlear dysplasia. This dissertation research confirmed the hypothesis that the efficacy of MPFL reconstruction in treating patellar instability decreases in cases with trochlear dysplasia. The findings of this study provide a deeper understanding of anatomical factors behind patellar instability, and will help clinicians determine the necessity of surgical treatments and select optimal treatment approaches on a patient-specific basis.
Rouzbeh Amini, Ph.D. (Committee Chair)
John Elias, Ph.D. (Advisor)
Brian Davis, Ph.D. (Committee Member)
Francis Loth, Ph.D. (Committee Member)
Ajay Mahajan, Ph.D. (Committee Member)
Henry Astley, Ph.D. (Committee Member)
97 p.
Biomechanics; Biomedical Engineering; Biomedical Research

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Citations

  • Rezvanifar, S. C. (2019). Computational Analysis and Anatomical Characterization of Trochlear Dysplasia in Patellar Instability [Doctoral dissertation, University of Akron]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=akron1571224864867381

    APA Style (7th edition)

  • Rezvanifar, Sayed Cyrus . Computational Analysis and Anatomical Characterization of Trochlear Dysplasia in Patellar Instability. 2019. University of Akron, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=akron1571224864867381.

    MLA Style (8th edition)

  • Rezvanifar, Sayed Cyrus . "Computational Analysis and Anatomical Characterization of Trochlear Dysplasia in Patellar Instability." Doctoral dissertation, University of Akron, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=akron1571224864867381

    Chicago Manual of Style (17th edition)

akron1571224864867381
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© 2019, all rights reserved.
This open access ETD is published by University of Akron and OhioLINK.