{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:45:49Z","timestamp":1792147549487,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82472527"],"award-info":[{"award-number":["82472527"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005088","name":"Beijing Municipal Health Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005088","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n The correction of high\u2010grade J\u2010sign 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\u2010sign among patients with patellar instability.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective study enrolled 120 knees diagnosed with recurrent patellar dislocation. Based on patellar tracking assessments, the J\u2010sign was categorized into a low\u2010grade group (J\u2010sign negative and Grade I) and a high\u2010grade group (J\u2010sign 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\u2010sign severity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Parameters 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\u2010grade group were significantly lower than that of the low\u2010grade group, while the SA was significantly higher than that of the low\u2010grade group (all\n p<\/jats:italic>\n \u2009<\u20090.01). At the trochlear groove entry plane, the area under the curve (AUC) values for distinguishing low\u2010grade and high\u2010grade J\u2010sign were as follows: AUC\n Trochlear depth<\/jats:sub>\n \u2009=\u20090.858, AUC\n SA<\/jats:sub>\n \u2009=\u20090.912, and AUC\n LTI<\/jats:sub>\n \u2009=\u20090.803. For SA, sensitivity was 0.87, specificity 0.87, and the optimal cutoff value 149.8\u00b0. In contrast, measurements at the Roman arch plane exhibited lower discriminative performance with AUC\n Trochlear depth<\/jats:sub>\n \u2009=\u20090.714, AUC\n SA<\/jats:sub>\n \u2009=\u20090.740, and AUC\n LTI<\/jats:sub>\n \u2009=\u20090.694. Specifically, SA demonstrated reduced sensitivity of 0.67, comparable specificity of 0.77, and a lower cutoff threshold of 140.2\u00b0.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n When 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\u2010sign compared to the Roman arch plane. Specifically, CT\u2010based measurement of the SA enables enhanced differentiation between low\u2010grade and high\u2010grade J\u2010sign subgroups, providing critical preoperative insights of patellar maltracking.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/os.70404","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:57:43Z","timestamp":1792144663000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trochlear Morphological Parameters Based on Measurements at the Trochlear Groove Entry Plane Demonstrate Excellent Predictive Efficacy for Identifying the High\u2010Grade J\u2010Sign"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9819-4779","authenticated-orcid":false,"given":"Jianzhong","family":"Sun","sequence":"first","affiliation":[{"name":"Sports Medicine Service Beijing Jishuitan Hospital, Capital Medical University Beijing China"},{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"},{"name":"Sports Medicine Service The Fourth Clinical Medical College of Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daofeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Sports Medicine Service Beijing Jishuitan Hospital, Capital Medical University Beijing China"},{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengjie","family":"Tang","sequence":"additional","affiliation":[{"name":"Sports Medicine Service Beijing Jishuitan Hospital, Capital Medical University Beijing China"},{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"},{"name":"Department of Orthopaedics Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Lv","sequence":"additional","affiliation":[{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"},{"name":"Sports Medicine Service The Fourth Clinical Medical College of Peking University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2405-7063","authenticated-orcid":false,"given":"Zhijun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Sports Medicine Service Beijing Jishuitan Hospital, Capital Medical University Beijing China"},{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianjiao","family":"Mao","sequence":"additional","affiliation":[{"name":"Sports Medicine Service Beijing Jishuitan Hospital, Capital Medical University Beijing China"},{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8329-1920","authenticated-orcid":false,"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Sports Medicine Service Beijing Jishuitan Hospital, Capital Medical University Beijing China"},{"name":"Beijing Research Institute of Traumatology and Orthopaedics Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"issue":"7","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1002\/ksa.12186","article-title":"Recurrent Patellar Dislocation Patients With High\u2010Grade J\u2010Sign Have Multiple Structural Bone Abnormalities in the Lower Limbs","volume":"32","author":"Wang D.","year":"2024","journal-title":"Knee Surgery, Sports Traumatology, Arthroscopy"},{"issue":"12","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"3849","DOI":"10.1007\/s00167-016-4346-0","article-title":"Assessment of Demographic and Pathoanatomic Risk Factors in Recurrent Patellofemoral Instability","volume":"25","author":"Hiemstra L. 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American Journal of Roentgenology"},{"issue":"1","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s00167-012-2321-y","article-title":"Evaluation of Trochlear Dysplasia Using MRI: Correlation Between the Classification System of Dejour and Objective Parameters of Trochlear Dysplasia","volume":"22","author":"Nelitz M.","year":"2014","journal-title":"Knee Surgery, Sports Traumatology, Arthroscopy"},{"issue":"5","key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1177\/03635465231158099","article-title":"Redefining Trochlear Dysplasia: Normal Thresholds Vary by Measurement Technique, Landmarks, and Sex","volume":"51","author":"Tanaka M. 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W.","year":"2000","journal-title":"Radiology"},{"issue":"3","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1002\/ksa.12418","article-title":"Medial Orientation of the Trochlear Groove is a Strong Indicator of High\u2010Grade Trochlear Dysplasia","volume":"33","author":"Mazy D.","year":"2025","journal-title":"Knee Surgery, Sports Traumatology, Arthroscopy"},{"issue":"6","key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1177\/0363546519838405","article-title":"Clinical Outcomes and Predictive Factors for Failure With Isolated MPFL Reconstruction for Recurrent Patellar Instability: A Series of 211 Reconstructions With a Minimum Follow\u2010Up of 3\u2009Years","volume":"47","author":"Sappey\u2010Marinier E.","year":"2019","journal-title":"American Journal of Sports Medicine"},{"issue":"7","key":"e_1_2_13_23_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.otsr.2021.103035","article-title":"Complications and Outcomes of Trochleoplasty for Patellofemoral Instability: A Systematic Review and Meta\u2010Analysis of 1000 Trochleoplasties","volume":"107","author":"Leclerc J. T.","year":"2021","journal-title":"Orthopaedics & Traumatology, Surgery & Research"},{"issue":"6","key":"e_1_2_13_24_1","doi-asserted-by":"crossref","DOI":"10.1148\/rg.220177","article-title":"Patellar Tracking: An Old Problem With New Insights","volume":"43","author":"Watts R. E.","year":"2023","journal-title":"Radiographics"},{"issue":"4","key":"e_1_2_13_25_1","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s00256-010-0961-x","article-title":"The Reliability and Validity of Radiological Assessment for Patellar Instability. A Systematic Review and Meta\u2010Analysis","volume":"40","author":"Smith T. 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A.","year":"2018","journal-title":"American Journal of Sports Medicine"},{"issue":"4","key":"e_1_2_13_28_1","first-page":"577","article-title":"The Effects of Articular, Retinacular, or Muscular Deficiencies on Patellofemoral Joint Stability: A Biomechanical Study in Vitro","volume":"87","author":"Senavongse W.","year":"2005","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"issue":"6","key":"e_1_2_13_29_1","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1002\/ksa.12166","article-title":"Shallow Trochlear Groove and Narrow Medial Trochlear Width at the Proximal Trochlea in Patients With Trochlear Dysplasia: A Three\u2010Dimensional Computed Tomography Analysis","volume":"32","author":"Lee J. Y.","year":"2024","journal-title":"Knee Surgery, Sports Traumatology, Arthroscopy"},{"issue":"1","key":"e_1_2_13_30_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.2214\/ajr.169.1.9207527","article-title":"Kinematic CT of the Patellofemoral Joint","volume":"169","author":"Dupuy D. E.","year":"1997","journal-title":"AJR. American Journal of Roentgenology"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70404","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.70404","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:57:47Z","timestamp":1792144667000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":29,"alternative-id":["10.1111\/os.70404"],"URL":"https:\/\/doi.org\/10.1111\/os.70404","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"2025-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"os.70404"}}