Guang-Ying Zhang1, Lei Zheng2, Hao Shi3, Bing-Jun Ji2, Yan Feng4, Hong-Yu Ding5. 1. Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University, 16766 Jingshi Rd, Li-Xia District, 250014, Jinan, China. 2. Department of Radiology, Shandong Provincial Corps Hospital of Chinese People's Armed Police Force, Jinan, 250014, China. 3. Department of Radiology, Shandong Provincial Qianfoshan Hospital of Shandong University, Jinan, 250014, China. 4. Department of Radiology, Affiliated Hospital of Binzhou Medical College, Binzhou, 256603, China. 5. Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University, 16766 Jingshi Rd, Li-Xia District, 250014, Jinan, China. qydinghy@163.com.
Abstract
OBJECTIVES: To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. METHODS: MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. RESULTS: Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). CONCLUSIONS: MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. KEY POINTS: • MPFL is most easily injured at its patellar insertion in children. • Wiberg patellar type B predisposes to complete MPFL tear. • No correlations between injury patterns of MPFL and other three anatomical variants. • Complete MPFL tear predisposes to higher grade patellar chondral lesion. • No correlations between injury locations of MPFL and patellar cartilage lesion.
OBJECTIVES: To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. METHODS: MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. RESULTS: Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). CONCLUSIONS: MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. KEY POINTS: • MPFL is most easily injured at its patellar insertion in children. • Wiberg patellar type B predisposes to complete MPFL tear. • No correlations between injury patterns of MPFL and other three anatomical variants. • Complete MPFL tear predisposes to higher grade patellar chondral lesion. • No correlations between injury locations of MPFL and patellar cartilage lesion.
Authors: Sabine Lippacher; David Dejour; Mohammed Elsharkawi; Daniel Dornacher; Christina Ring; Jens Dreyhaupt; Heiko Reichel; Manfred Nelitz Journal: Am J Sports Med Date: 2012-01-11 Impact factor: 6.202
Authors: Lars V von Engelhardt; Marthina Raddatz; Bertil Bouillon; Gunter Spahn; Andreas Dàvid; Patrick Haage; Thomas K Lichtinger Journal: BMC Musculoskelet Disord Date: 2010-07-05 Impact factor: 2.362
Authors: Marc A Tompkins; Sara R Rohr; Julie Agel; Elizabeth A Arendt Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-02-28 Impact factor: 4.342