Document Detail


Medial collateral ligament of the knee on magnetic resonance imaging: does the site of the femoral origin change at different patient ages in children and young adults?
MedLine Citation:
PMID:  20357586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The medial patellofemoral ligament (MPFL), a chief medial restraint preventing lateral patellar dislocation, often is reconstructed in children with recurrent dislocation. The femoral MPFL attachment can be difficult to delineate at surgery. Therefore, the origin of the medial collateral ligament (MCL) frequently is used to approximate the reattachment site. The purpose of our study was to compile normative data from MR imaging examinations over different patient ages, to determine the effect of growth on the relationship of the MCL origin site to the distal femoral physis and medial femoral condyle (MFC). SUBJECTS AND METHODS: This HIPAA-compliant study was IRB approved. Informed consent requirement was waived. Three hundred knee MR imaging examinations (143 boys, 157 girls, 0-20 y) were evaluated. MCL origin to femoral physis distance, MFC height, and MCL origin-physis distance: MFC height ratio (MCL:MFC ratio) were calculated. Relationships between these values and age, gender, and physeal patency were assessed using linear regression models. RESULTS: With physeal patency, MCL origin-physis distance was significantly associated with increasing age in boys (P=0.0394), and trended toward significance in girls (P=0.0557). Distance increased 0.01 cm/y in both genders. MFC height increased 0.15 cm/y in boys and 0.13 cm/y in girls (P<0.0001). MCL:MFC ratio decreased 0.01/y (P<0.0001). With physeal closure, no significant change was measured for any variable. CONCLUSIONS: During growth, there are statistically significant, albeit minimal, changes of the MCL origin-physis distance and MFC height. As these changes are essentially negligible, no adjustment for age is needed during restorative MPFL surgery in growing children. CLINICAL RELEVANCE: As there is neglible change in location of the origin of the MCL relative to the distal femoral physis during skeletal growth in both boys and girls, no adjustment for patient age is necessary when using the origin of the MCL as a landmark to locate the site of femoral reattachment of a disrupted MPFL.
Authors:
Patricia E Ladd; Tal Laor; Kathleen H Emery; Shelia R Salisbury; Shital N Parikh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  30     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:    2010 Apr-May
Date Detail:
Created Date:  2010-04-01     Completed Date:  2010-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  224-30     Citation Subset:  IM    
Affiliation:
Department of Radiology, Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Child
Child, Preschool
Epiphyses / anatomy & histology
Female
Femur / growth & development*
Humans
Infant
Knee Joint / anatomy & histology*,  surgery
Magnetic Resonance Imaging / methods*
Male
Patellar Dislocation / surgery
Patellar Ligament / anatomy & histology*,  surgery
Reconstructive Surgical Procedures / methods
Retrospective Studies
Sex Factors
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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