Article ; Online: Neither lateral patellar facet nor patellar size are altered in patellofemoral unstable patients: a comparative magnetic resonance imaging analysis.
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
2019 Volume 28, Issue 4, Page(s) 1064–1071
Abstract: Purpose: It remains unclear if morphologic patterns of the patella itself predispose to patellar instability. This study examined established patellar landmarks in relation to the femoral condyle width to clarify differences of patellar morphologies in ... ...
| Abstract | Purpose: It remains unclear if morphologic patterns of the patella itself predispose to patellar instability. This study examined established patellar landmarks in relation to the femoral condyle width to clarify differences of patellar morphologies in patellofemoral stable and unstable patients. Methods: Magnetic Resonance Imaging of 50 subjects (20.7 ± 4.4 years; 17 males, 33 females) with patellofemoral instability (study group, SG) and 50 subjects (25.3 ± 5.8 years; 31 males, 19 females) with anterior cruciate ligament rupture (control group, CG) were analyzed. Corresponding patellar value indices (PW-I; LPF-I 1; LPF-I 2) in relation to the femoral condyle width (FCW) were evaluated after the measurement of absolute patellar dimension [patellar width (PW); direct length of the lateral patellar facet (LPF-1); projected length of the lateral patellar facet (LPF-2)]. The patellar shape according to Wiberg, trochlear dysplasia, patellar height, and tibial tubercle-trochlear groove (TT-TG) distance were determined. Results: The SG showed a significantly longer absolute (LPF 2) (P = 0.041) and relative (LPF-I 1, LPF-I 2) (P < 0.001) lateral facet of the patella. No significant differences were evaluable for the relative patellar width (PW-I) (ns). A patellar shape type 3 (P = 0.001) as well as a higher position of the patella and TT-TG-distance (P < 0.001) were significantly more often present in the SG. Conclusion: There are several bony alterations associated with patellofemoral instability, but our data did not show a significantly smaller lateral patellar facet or relative patellar width that could facilitate a patellar dislocation. This helps surgeons, that are considering to surgically address the patella in cases of patellofemoral instability, to better understand its morphologic pattern. Level of evidence: III. |
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| MeSH term(s) | Adolescent ; Adult ; Anterior Cruciate Ligament Injuries/pathology ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Reconstruction ; Female ; Femur/pathology ; Humans ; Joint Instability/pathology ; Knee Joint/pathology ; Magnetic Resonance Imaging ; Male ; Patella/surgery ; Patellar Dislocation/diagnostic imaging ; Patellar Dislocation/surgery ; Patellofemoral Joint/diagnostic imaging ; Patellofemoral Joint/surgery ; Recurrence ; Tibia/surgery ; Young Adult |
| Language | English |
| Publishing date | 2019-08-27 |
| Publishing country | Germany |
| Document type | Comparative Study ; Journal Article |
| ZDB-ID | 1159064-6 |
| ISSN | 1433-7347 ; 0942-2056 |
| ISSN (online) | 1433-7347 |
| ISSN | 0942-2056 |
| DOI | 10.1007/s00167-019-05660-7 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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