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Erschienen in: European Radiology 4/2013

01.04.2013 | Musculoskeletal

Prevalence and patterns of anatomical risk factors in patients after patellar dislocation: a case control study using MRI

verfasst von: Torsten Köhlitz, Sven Scheffler, Tobias Jung, Arndt Hoburg, Bernd Vollnberg, Edzard Wiener, Gerd Diederichs

Erschienen in: European Radiology | Ausgabe 4/2013

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Abstract

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.
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Metadaten
Titel
Prevalence and patterns of anatomical risk factors in patients after patellar dislocation: a case control study using MRI
verfasst von
Torsten Köhlitz
Sven Scheffler
Tobias Jung
Arndt Hoburg
Bernd Vollnberg
Edzard Wiener
Gerd Diederichs
Publikationsdatum
01.04.2013
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 4/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2696-7

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