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Prevalence and patterns of anatomical risk factors in patients after patellar dislocation: a case control study using MRI.
MedLine Citation:
PMID:  23192374     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To assess anatomical risk factors in patients after lateral patellar dislocation (LPD) and controls using MRI. METHODS: MR images of 186 knees after LPD and of 186 age- and gender-matched controls were analysed. The presence of trochlear dysplasia was assessed by evaluation of trochlear inclination, facet asymmetry, and trochlear depth; patella alta was evaluated by the Insall-Salvati index and Caton-Deschamps index; the lateralised force vector was measured by the tibial tuberosity-trochlear groove (TT-TG) distance. RESULTS: Compared with controls, dislocators had significantly lower values for all three parameters of trochlear dysplasia (-32 %, -32 %, -44 %) and significantly higher values for patella alta (+14 %,+13 %) and TT-TG (+49 %) (all P < 0.001). Trochlear dysplasia was observed in 112 dislocators (66 %), of whom 61 (36 %) additionally had patella alta and 15 (9 %) an abnormal TT-TG. As isolated risk factors, patella alta (15 %) and abnormal TT-TG (1 %) were rare. Only 25 dislocators (15 %) had no anatomical risk factors. Trochlear dysplasia in conjunction with abnormal TT-TG or patella alta is associated with a 37- and 41-fold higher risk. CONCLUSION: Most dislocators have anatomical risk factors, varying in severity and constellation. KEY POINTS : • Magnetic resonance imaging provides unique information about anatomical variation within the knee. • Anatomical variants increase the risk for lateral patellar dislocation (LPD) • Trochlear dysplasia is the main risk factor for LPD. • Patellar alta and abnormal tibial tuberosity-trochlear groove distance may be additional factors. • Patient-specific evaluation of risk factors following LPD may help future management.
Torsten Köhlitz; Sven Scheffler; Tobias Jung; Arndt Hoburg; Bernd Vollnberg; Edzard Wiener; Gerd Diederichs
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  European radiology     Volume:  -     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Radiology, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Chariteplatz 1, 10117, Berlin, Germany,
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