Type of Article:  Original Research

Volume 8; Issue 3.2 (August 2020)

Page No.: 7649-7653

DOI: https://dx.doi.org/10.16965/ijar.2020.176


Lakati Kevin Christopher *, Arisi Kerubo, Yegon Fred, Mwaniki Mark, Mutero Flora.

Department of Human Anatomy, Faculty of Health Sciences, Egerton University, Kenya.

Corresponding Author: Lakati Kevin Christopher, Lecturer, Department of Human Anatomy, Faculty of Health Sciences, P.O. Box 536-20115. Egerton University, Kenya. E-Mail: klakati@yahoo.com


Background: The trochlea sulcus and lateral trochlea inclination angles have important implications in the biomechanics of the patellofemoral joint. Abnormalities of these angles have been implicated in patella instability, anterior knee pain and patella complications after both total knee and patellofemoral arthroplasty.

Objective: To measure the trochlea sulcus and lateral trochlea inclination angles on dried unpaired Kenyan femora.

Methods: The angles were measured on end-on digital images of grossly normal femora using an open source image analysis software, ImageJ®. Measures of central tendency were calculated.

Results: Average trochlea sulcus and lateral trochlea inclination angles were 1390 and 210 respectively. There was no significant difference between the angles in the right and left femora. There was a negative correlation between the sulcus and lateral trochlea inclination angles. These angles are comparable to values in other populations.

Conclusion: Average sulcus angle in Kenyan femora is 139º and the average lateral trochlea inclination angle 210, with no significant difference between right and left sides. These can be used as guide when analyzing diagnostic images of the knee for patella instability.

Key words: Trochlea Sulcus Angle, Lateral Trochlea Inclination, Patella Instability.


  1. Harbaugh CM, Wilson NA, Sheehan FT. Correlating femoral shape with patellar kinematics in patients with patellofemoral pain. J Orthop Res. 2010;28(7):865-872.
    https://doi.org/10.1002/jor.21101 PMid:20108348 PMCid:PMC3269909
  2. Brattström H. Shape of the Intercondylar Groove Normally and in Recurrent Dislocation of Patella: A Clinical and X-Ray Anatomical Investigation. Acta Orthop Scand. 1964 May;35(sup68):1-148. https://doi.org/10.3109/ort.1964.35.suppl-68.01
  3. Davies-Tuck M, Teichtahl AJ, Wluka AE, Wang Y, Urquhart DM, Cui J, et al. Femoral sulcus angle and increased patella facet cartilage volume in an osteoarthritic population. Osteoarthritis Cartilage. 2008;16(1):131-135. https://doi.org/10.1016/j.joca.2007.08.002 PMid:17869546
  4. Macri EM, Culvenor AG, Morris HG, Whitehead TS, Russell TG, Khan KM, et al. Lateral displacement, sulcus angle and trochlear angle are associated with early patellofemoral osteoarthritis following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2018;26(9):2622-2629.
    https://doi.org/10.1007/s00167-017-4571-1 PMid:28488001
  5. Carrillon Y, Abidi H, Dejour D, Fantino O, Moyen B, Tran-Minh VA. Patellar instability: assessment on MR images by measuring the lateral trochlear inclination-initial experience. Radiology. 2000 Aug;216(2):582-5. https://doi.org/10.1148/radiology.216.2.r00au07582 PMid:10924589
  6. Russell RD, Huo MH, Jones RE. Avoiding patellar complications in total knee replacement. Bone Joint J. 2014;96-B:84-86 https://doi.org/10.1302/0301-620X.96B11.34305 PMid:25381415
  7. Malo M, Vince KG. The Unstable Patella After Total Knee Arthroplasty: Etiology, Prevention, and Management. JAAOS – J Am Acad Orthop Surg. 2003 Oct;11(5):364-371. https://doi.org/10.5435/00124635-200309000-00009 PMid:14565758
  8. Kamath AF, Slattery TR, Levack AE, Wu CH, Kneeland JB, Lonner JH. Trochlear inclination angles in normal and dysplastic knees. J Arthroplasty. 2013 Feb;28(2):214-9. https://doi.org/10.1016/j.arth.2012.04.017 PMid:22704031
  9. Saffarini M, Ntagiopoulos PG, Demey G, Le Negaret B, Dejour DH. Evidence of trochlear dysplasia in patellofemoral arthroplasty designs. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2574-2581. https://doi.org/10.1007/s00167-014-2967-8 PMid:24696005
  10. Murshed – Femoral Sulcus Angle Measurements An Anatomical S.pdf [Internet]. [cited 2020 Mar 16]. Available from: http://journals.tubitak.gov.tr/medical/issues/sag-04-34-3/sag-34-3-3-0306-13.pdf
  11. Mwakikunga A, Katundu K, Msamati B, Adefolaju AG, Schepartz L. An anatomical and osteometric study of the femoral sulcus angle in adult Malawians. Afr Health Sci. 2016;16(4):1182-7. https://doi.org/10.4314/ahs.v16i4.38 PMid:28479913 PMCid:PMC5398467
  12. Qin J, Chen D, Xu Z, Shi D, Dai J, Jiang Q. Evaluation of the Effect of the Sulcus Angle and Lateral to Medial Facet Ratio of the Patellar Groove on Patella Tracking in Aging Subjects with Stable Knee Joint. BioMed Res Int. 2018; 2018:1-5.
    https://doi.org/10.1155/2018/4396139 PMid:29854753 PMCid:PMC5964416
  13. Davies AP, Bayer J, Owen-Johnson S, Shepstone L, Darrah C, Glasgow MM, et al. The optimum knee flexion angle for skyline radiography is thirty degrees. Clin Orthop Relat Res 2004;423: 166-171. https://doi.org/10.1097/01.blo.0000129160.07965.e7 PMid:15232444
  14. Saffarini M, Demey G, Nover L, Dejour D. Evolution of trochlear compartment geometry in total knee arthroplasty. Ann Transl Med. 2016;4(1).
  15. Nietosvaara Y. The femoral sulcus in children. An ultrasonographic study. J Bone Joint Surg Br. 1994 Sep;76-B(5):807-9. https://doi.org/10.1302/0301-620X.76B5.8083274
  16. Glard Y, Jouve JL, Panuel M et al. An anatomical and biometrical study of the femoral trochlear groove in the human fetus. J Anat. 2005;206:411-413.
    https://doi.org/10.1111/j.1469-7580.2005.00400.x PMid:15817109 PMCid:PMC1571485
  17. Osman NM, Ebrahim SM. Patellofemoral instability: Quantitative evaluation of predisposing factors by MRI. Egypt J Radiol Nucl Med. 2016;47(4):1529-1538.
  18. Van Huyssteen AL, Hendrix MRG, Barnett AJ, Wakeley CJ, Eldridge JDJ. Cartilage-bone mismatch in the dysplastic trochlea: AN MRI STUDY. J Bone Joint Surg Br. 2006 May;88-B(5):688-91. https://doi.org/10.1302/0301-620X.88B5.16866
  19. Merchant AC, Mercer RL, Jacobsen RH, Cool CR. Roentgenographic Analysis of Patellofemoral Congruence. JBJS. 1974 Oct;56(7):1391-1396. https://doi.org/10.2106/00004623-197456070-00007
  20. Stefanik JJ, Roemer FW, Zumwalt AC, Zhu Y, Gross KD, Lynch JA, Frey-Law LA, Lewis CE, Guermazi A, Powers CM, Felson DT. Association between measures of trochlear morphology and structural features of patellofemoral joint osteoarthritis on MRI: the MOST study. J Orthop Res 2012;30:1-8. https://doi.org/10.1002/jor.21486 PMid:21710542 PMCid:PMC3217080
  21. Varadarajan KM, Rubash HE, Li G. Are current total knee arthroplasty implants designed to restore normal trochlear groove anatomy? J Arthroplasty. 2011;26(2):274-281. https://doi.org/10.1016/j.arth.2009.12.009 PMid:20171042

Cite this article: Lakati Kevin Christopher, Arisi Kerubo, Yegon Fred, Mwaniki Mark, Mutero Flora. TROCHLEA SULCUS AND LATERAL TROCHLEA INCLINATION ANGLES IN KENYANS: AN OSTEOMETRIC STUDY. Int J Anat Res 2020;8(3.2):7649-7653. DOI: 10.16965/ijar.2020.176