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Topic:

Patellar Instability

Issue:

Knee

Category:

Trauma

Title:

Patellar Lateralization, Absence of Joint Hypermobility, and the Mechanism of Injury Are Associated With Osteochondral Fracture After First-time Acute Lateral Patellar Dislocation in Adolescents: An MRI-based Evaluation

Author:

İğrek, Servet MD; Şahbat, Yavuz MD; Koç, Erdem MD; Çeliksöz, Aytek Hüseyin MD; Topkar, Osman Mert MD

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4):p 273-280, DOI: 10.1097/BPO.0000000000002629

Level Of Evidence:

III

# of Patients:

306

Study Type:

Retrospective cohort study

Location:

Multicenter

Summary:

This study examines risk factors for osteochondral fractures (OCFs) in patients with first-time acute lateral patellar dislocation, evaluating MRI findings and patient characteristics. Key focus areas include patellar lateralization, trochlear morphology, joint hypermobility, and injury mechanisms.

Methods:

Retrospective analysis of MRIs and patient data. Divided patients into OCF and non-OCF groups. Evaluated patellar height, lateralization, trochlear morphology, patellofemoral matching, and injury mechanisms. Used Beighton scale for assessing joint hypermobility.

Exclusions:

Not specified

Results:

120 OCFs detected in 108 patients (35.2%), with 80% in the patella and 20% in the femur. OCF was more common in sports-related injuries (P=0.001). Patients without joint hypermobility had higher OCF rates (P=0.041). Measurements of tibial tubercle–trochlear groove distance, tibial tubercle–posterior cruciate ligament distance, and lateral patellar displacement were higher in OCF cases (P=0.001). OCF in the patella was more common in patients with normal joint mobility (P=0.035).

Conclusions:

Absence of joint hypermobility and patellar lateralization are independent risk factors for OCF after first-time patellar dislocation. Sports-related injuries are a non-independent risk factor. MRI findings should guide clinical evaluation and treatment planning.

Relevance:

Limitations:

Perspective:

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