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Morphology and Anat...
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Askenberger, MKarolinska Institutet
(author)
Morphology and Anatomic Patellar Instability Risk Factors in First-Time Traumatic Lateral Patellar Dislocations: A Prospective Magnetic Resonance Imaging Study in Skeletally Immature Children
- Article/chapterEnglish2017
Publisher, publication year, extent ...
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2016-10-01
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SAGE Publications,2017
Numbers
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LIBRIS-ID:oai:prod.swepub.kib.ki.se:134974517
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http://kipublications.ki.se/Default.aspx?queryparsed=id:134974517URI
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https://doi.org/10.1177/0363546516663498DOI
Supplementary language notes
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Language:English
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Summary in:English
Part of subdatabase
Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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The incidence of primary lateral patellar dislocation (LPD) in children aged 9 to 14 years is 0.6 to 1.2 per 1000. Causation is assumed to be multifactorial, including anatomic variants of the patellofemoral (PF) joint that result in a higher risk of LPD. No publication has compared the morphology of the PF joint and anatomic patellar instability risk factors (APIFs) in a primary LPD population versus controls, defining children by skeletal maturity. Purpose: To characterize the PF morphology and APIFs (trochlear dysplasia, abnormal lateral patellar tilt, elevated tibial tubercle–trochlear groove [TT-TG] distance, patella alta) through magnetic resonance imaging (MRI) measurements in skeletally immature children with and without a primary LPD and to identify (potential) distinctive differences between these 2 groups. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A prospective series of 103 skeletally immature children aged 9 to 14 years with an MRI-confirmed primary LPD were matched with a control group of 69 children. The PF morphology and APIFs were assessed during a 2.5-year period with standardized MRI using sagittal and axial views. Results: In the LPD group, 79% had 2 to 4 APIFs compared with 7% in the control group. All major measurements of trochlear dysplasia were significantly different between the 2 groups. The mean central condylar height was significantly higher in the LPD group compared with the control group, resulting in a lower trochlear depth (2.3 vs 4.5 mm, respectively) and higher sulcus angle (156.7° vs 141.1°, respectively). The LPD group had significantly higher values of patellar height, Caton-Deschamps index (1.33 vs 1.15, respectively), lateral patellar tilt (21.1° vs 8.5°, respectively), and TT-TG distance (13.9 vs 9.8 mm, respectively) compared with the control group. The main divergent APIF was trochlear dysplasia (defined as trochlear depth <3 mm), seen in 74% of the LPD group compared with 4% of the control group. Elevated TT-TG distance as a single APIF was never present in the LPD group; patellar tilt was only seen in the LPD group. The most common APIF in the control group was patella alta (36%). Conclusion: There was a significant difference in mean values of all established APIFs between the children with a first-time LPD and the controls. Trochlear dysplasia was the main APIF, and together with lateral patellar tilt (≥20°), they had the strongest association with LPD.
Added entries (persons, corporate bodies, meetings, titles ...)
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Janarv, PMKarolinska Institutet
(author)
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Finnbogason, TKarolinska Institutet
(author)
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Arendt, EA
(author)
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Karolinska Institutet
(creator_code:org_t)
Related titles
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In:The American journal of sports medicine: SAGE Publications45:1, s. 50-581552-33650363-5465
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