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Sports 2016, 4(2), 24; doi:10.3390/sports4020024

Radiographic Assessment of Anatomic Risk Factors Associated with Acute, Lateral Patellar Dislocation in the Immature Knee

1
Mount Carmel Health Systems, Department of Orthopedics 793 West State Street Columbus, Columbus, OH 43222, USA
2
Ohio State University Medical Center, Department of Orthopaedics, 410 W 10th Ave, Columbus, OH 43210, USA
3
Nationwide Children’s Hospital, Department of Orthopedics, 700 Children’s Drive, Ste. A2630, Columbus, OH 43205-2696, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Craig Williams
Received: 14 March 2016 / Revised: 11 April 2016 / Accepted: 14 April 2016 / Published: 15 April 2016
(This article belongs to the Special Issue Paediatric Exercise Physiology)
View Full-Text   |   Download PDF [3345 KB, uploaded 15 April 2016]   |  

Abstract

Acute patellar dislocation remains a common injury in both adult and pediatric patients. Non-operative management has been advocated for patients without a history of recurrent instability. Although pathologic thresholds for consideration of operative management have previously been reported in adults, it is largely unknown in children. A retrospective review of all skeletally immature patients diagnosed with acute lateral patellar dislocation who had MRI imaging were included for analysis. An age-based control group was also identified. Six radiographic measurements were compared: lateral trochlear inclination (LTI), trochlear facet asymmetry (TFA), trochlear depth (TD), tibial tuberosity–trochlear groove (TT–TG), sulcus angle (SA) and patellar height ratio. A total of 178 patients were included for analysis (study: n = 108, control: n = 70). The mean age of patients in the study and control groups was 13.7 and 12.1 years respectively (p ≤ 0.001). Study group patients had significant differences in all radiographic measurements including a decreased LTI (p < 0.001), increased TFA (p < 0.001) and SA (p < 0.001). The mean trochlear depth was 3.4 mm and 5.6 mm for patients in the study and control groups respectively (p < 0.001). Study group patients had an increased patellar height ratio (p < 0.001) and TT–TG distance (p < 0.001). Morphologic abnormalities may predispose skeletally immature patients to an increased risk of acute lateral patellar instability. View Full-Text
Keywords: children; knee; magnetic resonance imaging; morphology; patella; patellofemoral joint children; knee; magnetic resonance imaging; morphology; patella; patellofemoral joint
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Trinh, T.; Mundy, A.; Beran, M.; Klingele, K. Radiographic Assessment of Anatomic Risk Factors Associated with Acute, Lateral Patellar Dislocation in the Immature Knee. Sports 2016, 4, 24.

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