First-time patellar dislocation typically occurs with twisting knee motions, during which the medial ligamentous stabilizers rupture, and the patella strikes against the lateral femoral condyle. The typical injury pattern is a tear of the medial patellofemoral ligament (MPFL) and bone bruises of the patella and the lateral femoral condyle. Additionally, complex injuries to bone, cartilage, and ligaments may occur. The ensuing loss of medial restraint favors future patellar dislocations, especially if additional risk factors are present. Recurrent patellar dislocations usually occur in individuals with anatomic variants of the patellar stabilizers, such as trochlear dysplasia, patella alta, and lateralization of the tibial tuberosity. Magnetic resonance (MR) imaging is reliable in identifying risk factors for chronic patellar instability and in assessing knee joint damage associated with patellar dislocation. MR imaging can thus provide important information for individually tailored treatment. Patients with primary patellar dislocation without severe internal derangement who lack major risk factors can be treated conservatively. Patients with pronounced ligamentous tears or large osteochondral lesions require prompt surgery. In addition, surgical correction of anatomic variants will help reduce the potential for chronic instability. The most common procedures, in addition to MPFL reconstruction, include trochleoplasty, medialization of the tibial tuberosity, and medial capsular plication. For comprehensive assessment of patellar dislocation, a radiologist should be able to identify typical injury patterns, know standard methods to assess risk factors for patellar instability, and be familiar with surgical options.
Our results suggest that some patients with nontraumatic patellar instability have greater internal femoral rotation, greater knee rotation, and a tendency for genu valgum compared with healthy controls. Rotational malalignment may be a primary risk factor in patellar dislocation that has so far been underestimated.
The biomechanical behavior of the osteosynthesis depends more on plate configuration than plate type. Advantages of locking compression plates are only significant if compared with dorsal plate application techniques. Nevertheless, locking compression plates are helpful supplementary tools for achieving primary stable fracture fixation. This might be of considerable clinical relevance in patients with diminished bone mineral quality or in the presence of metaphyseal comminution.
• Cartilage lesions are very common after patellar dislocation. • The severity of cartilage lesions increases with number of dislocations. • Osteoarthritis is common after recurrent patellar dislocation, even in young patients. • Detecting cartilage lesions is important after patellar dislocation.
This biodistribution study provided a broad range of uptake data of [(68)Ga]PSMA-11 for normal organs/tissues, primary prostate tumours and metastatic lesions based on a large patient cohort. Both PT and small metastatic lesions were detectable due to their high tracer uptake. Four-times-higher median uptake in PT in comparison to normal prostate stroma resulted in a high diagnostic accuracy that could potentially be used for multimodal image-guided biopsy with dedicated reconstruction software.
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