High incidence of acute and recurrent patellar dislocations: a retrospective nationwide epidemiological study involving 24.154 primary dislocations

Gravesen, Kasper Skriver; Kallemose, Thomas; Blønd, Lars; Troelsen, Anders; Barfod, Kristoffer Weisskirchner

doi:10.1007/s00167-017-4594-7

Cited by 71 publications

(110 citation statements)

References 22 publications

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“…It may be triggered by traumatic or nontraumatic events [2]. About 15-44% of patients who are treated conservatively after an acute dislocation will have recurrent patellar dislocation [3,4]. Patients with anatomic variations such as a large Q angle, patella alta, femoral trochlear dysplasia, and arthrochalasis are particularly prone to recurrence [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

Gao

Liu

2020

J Orthop Surg Res

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Background: The purpose of this study was to retrospectively analyze the clinical outcomes of patients with recurrent patellar dislocation who underwent arthroscopic medial patellofemoral ligament (MPFL) reconstruction using gracilis tendon autograft and a modified double-patellar tunnel method. We hypothesized that our modified method would provide good clinical outcomes. Methods: Patients who underwent arthroscopic MPFL reconstruction with autograft gracilis tendon and modified double-patellar tunnels technique for recurrent patellar dislocation and were followed up for a minimum of 5 years were identified, and the clinical and follow-up data were retrospectively analyzed. Preoperatively, joint hypermobility was assessed with the Beighton score. The Insall-Salvati ratio, TT-TG distance, and Q angle were measured on radiographic images. Patient-reported outcomes including the Kujala, Lysholm, and Tegner scores were collected preoperatively and postoperatively. Patient satisfaction was assessed at the end of 5 years. Complications and recurrent dislocation occurring after surgery were recorded. Results: A total of 79 patients (94 knees) were enrolled; of these, 13 (16.5%) were lost to follow-up. The data of 66 patients (80 knees) were available for final analysis. Mean age at surgery was 21.3 ± 7.8 years. Mean follow-up time was 66.1 ± 5.5 months (range, 60-78 months). Postoperative patient-reported outcome was not associated with Beighton score, Insall-Salvati ratio, or TT-TG distance. Q angle was negatively correlated to Kujala scores and Lysholm scores. Severity of trochlear dysplasia was not associated with postoperative patient-reported outcome. The mean Kujala score increased from 69.4 ± 7.9 to 96.1 ± 1.9, the mean Tegner score increased from 3.1 ± 1.3 to 5.9 ± 1.3, and the mean Lysholm score increased from 73.5 ± 14.6 to 95.3 ± 3.4. Two patients experienced recurrent patellar dislocation during follow-up. Conclusions: MPFL reconstruction using autologous gracilis tendon under arthroscopy appears to be a reliable and safe method for treating recurrent patellar dislocation. Level of evidence: Level IV.

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Section: Introductionmentioning

confidence: 99%

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

Gao

Liu

2020

J Orthop Surg Res

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“…Acute primary patellar dislocation (APPD) accounts for 2-3% of knee injuries [1], and mostly occurs in adolescents and active people [2]. The incidence of APPD is 5.8-42 per 100,000 [3,4]. Patellar dislocation can be caused by trauma or anatomical abnormalities [5,6].…”

Section: Introductionmentioning

confidence: 99%

Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials

2020

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Purpose: The objective of this study was to conduct the latest meta-analysis of randomized controlled trials (RCTs) that compare clinical results between surgery and conservative therapy of acute primary patellar dislocation (APPD), focusing on medial patellofemoral ligament (MPFL) reconstruction. Methods: We performed a literature search in Embase, The Cochrane Library, PubMed, and Medline to identify RCTs comparing APPD surgical treatment with conservative treatment from the establishment of each database to January 2019. The methodological quality of each RCT was assessed independently by the two authors through the Cochrane Collaboration's "Risk of Bias" tool. Mean differences of continuous variables and risk ratios of dichotomous variables were computed for the pooled data analyses. The I 2 statistic and the χ 2 test were used to evaluate heterogeneity, with the significance level set at I 2 > 50% or P < 0.10. Results: Ten RCTs with a sum of 569 patients (297 receiving surgical treatment and 263 receiving conservative treatment) met the inclusion criteria for meta-analysis. Pooled data analysis showed no statistical difference in the field of subluxation rate, Kujala score, patient satisfaction, and frequency of reoperation between the two groups. Tegner activity score and recurrent dislocation rate in the conservative group were significantly higher than those in the surgically treated group. Conclusions: Conservative treatment may produce better outcomes than surgery for APPD in consideration of Tegner activity score. However, in view of limited research available, the interpretation of the discoveries should be cautious. More convincing evidence is required to confirm the effect of MPFL reconstruction.

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“…Recurrent lateral patellar dislocation (LPD) is usually secondary to the primary acute patellar dislocation, which mostly occurs in young people aged 10-17 years, with an incidence of three times as many men suffer from this disease as women (1). The incidence of primary acute patella dislocation in general public is 7 to 49 cases per 100,000 (2,3). With nonoperative management, the rate of recurrent LPD after acute patellar dislocation was reported to be up to 44% (4).…”

Section: Introductionmentioning

confidence: 99%

Morphological study of vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images

Shu

Yang

et al. 2020

Preprint

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Purpose To investigate the morphological parameters of the vastus medialis obliquus (VMO) muscle and delineate its importance in the maintenance of patellofemoral joint stability.Methods The magnetic resonance imaging (MRI) data of 75 knees (54 patients) with recurrent lateral patella dislocation (LPD) and 75 knees (70 patients with similar age, gender and body mass index) were retrospectively analyzed. Five morphological parameters related to VMO (elevation on sagittal plane and coronal plane, cross-sectional area ratio, craniocaudal extent, muscle-fiber angulation,) and two parameters of patella tilt (patella tilt angle, bisect offset ratio) were measured in MRI images, and the types of trochlear in each patient were recorded. Finally, the differences of these parameters between the two groups were analyzed.Results Compared with the control group, the patients with recurrent LPD showed significantly higher in sagittal VMO elevation (10.4 ± 2.3 mm vs 4.1 ± 1.9 mm), coronal VMO elevation (15.9 ± 5.7 mm vs 3.9 ± 3.7 mm), muscle-fiber angulation (35.4 ± 8.0° vs 27.9 ± 6.3°), patella tilt angle (25.9 ± 10.7° vs 9.1 ± 5.2°), and bisect offset ratio values (0.9 ± 0.3 vs 0.5 ± 0.1), and significantly lower in craniocaudal extent (13.7 ± 5.3mm vs 16.7 ± 5.1 mm) and cross-sectional area ratio values (0.07 ± 0.02 vs 0.05 ± 0.02).Conclusions The results showed that the abnormality of VMO were clearly present in recurrent LPD patients compared with normal people, which may be an important factor of patella tilt in LPD patients, so it is necessary to focus on injury condition of VMO during preoperative evaluation.

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High incidence of acute and recurrent patellar dislocations: a retrospective nationwide epidemiological study involving 24.154 primary dislocations

Abstract: IV.

Cited by 71 publications

References 22 publications

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes

Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials

Morphological study of vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images

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