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Magnetic Resonance Imaging Findings After Acute Patellar Dislocation in Children.

Wilson A, Afarin A, Shaw C, Shirley E, Pierce J, Slakey JB - Orthop J Sports Med (2013)

Bottom Line: There was a significant correlation identified between MPFL rupture and both LPR thickness greater than 3 mm and TTTG distance greater than 19 mm.The MPFL does not always tear in children who sustain APD, and the tear location is variable.A thickened LPR and increased TTTG distance predispose to MPFL tear.

View Article: PubMed Central - PubMed

Affiliation: Bone & Joint Sports Medicine Institute, Naval Medical Center, Portsmouth, Virginia, USA.

ABSTRACT

Background: Acute patellar dislocation (APD) is a common knee injury in children. The pattern and frequency of injury to the medial patellofemoral ligament (MPFL) is different in pediatric compared with adult populations.

Purpose: To report on injury patterns sustained to the MPFL after APD in children and to determine whether predisposing factors for APD cited in adults hold true in the pediatric population.

Study design: Case series; Level of evidence, 4.

Methods: Magnetic resonance imaging (MRI) studies were reviewed for 36 children sustaining APD. Evidence of injury to the MPFL was documented, and when the MPFL was torn, the location of tear was determined. Presence of trochlear dysplasia, patella alta, tibial tubercle-trochlear groove (TTTG) distance, and thickness of the lateral patellofemoral retinaculum (LPR) were recorded and correlated with MPFL tear.

Results: Of the 36 patients sustaining APD, only 16 tore the MPFL. The location of MPFL tear was equally divided between the origin, the insertion, or both, with no case of midsubstance tear. There was a significant correlation identified between MPFL rupture and both LPR thickness greater than 3 mm and TTTG distance greater than 19 mm.

Conclusion: The MPFL does not always tear in children who sustain APD, and the tear location is variable. A thickened LPR and increased TTTG distance predispose to MPFL tear.

No MeSH data available.


Related in: MedlinePlus

Axial T2-weighted image with fat saturation demonstrating a femoral-sided medial patellofemoral ligament tear (thin arrow) with thickening of the lateral patellofemoral retinaculum. Classic bone edema pattern is present involving the inferomedial patella and the lateral femoral condyle (thick arrows).
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fig2-2325967113512460: Axial T2-weighted image with fat saturation demonstrating a femoral-sided medial patellofemoral ligament tear (thin arrow) with thickening of the lateral patellofemoral retinaculum. Classic bone edema pattern is present involving the inferomedial patella and the lateral femoral condyle (thick arrows).

Mentions: MRI revealed MPFL injury in only 21 patients (58%), with 16 identified as tears and 5 as sprains. Of those with MPFL tear, there was a balanced distribution for location of tear: 5 torn at origin (Figure 1), 6 torn at insertion (Figure 2), and 5 with tears at both origin and insertion. There were no intrasubstance tears identified.


Magnetic Resonance Imaging Findings After Acute Patellar Dislocation in Children.

Wilson A, Afarin A, Shaw C, Shirley E, Pierce J, Slakey JB - Orthop J Sports Med (2013)

Axial T2-weighted image with fat saturation demonstrating a femoral-sided medial patellofemoral ligament tear (thin arrow) with thickening of the lateral patellofemoral retinaculum. Classic bone edema pattern is present involving the inferomedial patella and the lateral femoral condyle (thick arrows).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4555511&req=5

fig2-2325967113512460: Axial T2-weighted image with fat saturation demonstrating a femoral-sided medial patellofemoral ligament tear (thin arrow) with thickening of the lateral patellofemoral retinaculum. Classic bone edema pattern is present involving the inferomedial patella and the lateral femoral condyle (thick arrows).
Mentions: MRI revealed MPFL injury in only 21 patients (58%), with 16 identified as tears and 5 as sprains. Of those with MPFL tear, there was a balanced distribution for location of tear: 5 torn at origin (Figure 1), 6 torn at insertion (Figure 2), and 5 with tears at both origin and insertion. There were no intrasubstance tears identified.

Bottom Line: There was a significant correlation identified between MPFL rupture and both LPR thickness greater than 3 mm and TTTG distance greater than 19 mm.The MPFL does not always tear in children who sustain APD, and the tear location is variable.A thickened LPR and increased TTTG distance predispose to MPFL tear.

View Article: PubMed Central - PubMed

Affiliation: Bone & Joint Sports Medicine Institute, Naval Medical Center, Portsmouth, Virginia, USA.

ABSTRACT

Background: Acute patellar dislocation (APD) is a common knee injury in children. The pattern and frequency of injury to the medial patellofemoral ligament (MPFL) is different in pediatric compared with adult populations.

Purpose: To report on injury patterns sustained to the MPFL after APD in children and to determine whether predisposing factors for APD cited in adults hold true in the pediatric population.

Study design: Case series; Level of evidence, 4.

Methods: Magnetic resonance imaging (MRI) studies were reviewed for 36 children sustaining APD. Evidence of injury to the MPFL was documented, and when the MPFL was torn, the location of tear was determined. Presence of trochlear dysplasia, patella alta, tibial tubercle-trochlear groove (TTTG) distance, and thickness of the lateral patellofemoral retinaculum (LPR) were recorded and correlated with MPFL tear.

Results: Of the 36 patients sustaining APD, only 16 tore the MPFL. The location of MPFL tear was equally divided between the origin, the insertion, or both, with no case of midsubstance tear. There was a significant correlation identified between MPFL rupture and both LPR thickness greater than 3 mm and TTTG distance greater than 19 mm.

Conclusion: The MPFL does not always tear in children who sustain APD, and the tear location is variable. A thickened LPR and increased TTTG distance predispose to MPFL tear.

No MeSH data available.


Related in: MedlinePlus