Sonographic Appearances of Medial Retinacular Complex Injury in Transient Patellar Dislocation

O'reilly, M. A. R.; O'Reilly, Philip; Bell, Jonathan

doi:10.1016/s0009-9260(03)00137-5

Cited by 30 publications

(10 citation statements)

References 19 publications

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“…6,14,27,37 In all but 2 cases in the analyzed group, the patellar attachment injury had a form of avulsion fracture of the medial patellar border with a thin sleeve of bony fragment attached to the ligament fibers ( Figure 1B), and such a high frequency of avulsion fractures of the medial patellar border in TPD had not yet been reported. 13,18,19,23,27,34,45 We suppose that this frequent occurrence of avulsion patellar fractures might be related to the age of our patients. As described by Ogden 33 and Stanitski et al, 42 the medial patellar border, constituting the patellar attachment of the MPFL, remains cartilaginous until age 16 to 18 years, in contrast to the distal femoral epiphysis (femoral MPFL attachment), which ossifies earlier, usually at age 13 to 15 years.…”

Section: Felus and Kowalczykmentioning

confidence: 80%

Age-Related Differences in Medial Patellofemoral Ligament Injury Patterns in Traumatic Patellar Dislocation

Feluś

Kowalczyk

2012

Am J Sports Med

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Section: Felus and Kowalczykmentioning

confidence: 80%

Age-Related Differences in Medial Patellofemoral Ligament Injury Patterns in Traumatic Patellar Dislocation

Feluś

Kowalczyk

2012

Am J Sports Med

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“…In patellar dislocation, the main medial stabilizing structure of the patella, the medial patellofemoral ligament, has been shown to be injured in practically every case. 13,14,17,26 After primary patellar dislocation and medial patellofemoral ligament injury, the biomechanics of patellar dislocation alter with recurrent dislocations, as the patella is more easily able to move laterally. As a result, the patella may dislocate after low-energy trauma with lower impact on the articular surfaces of the patellofemoral joint.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Osteochondral Fractures Caused by Patellar Dislocation

Uimonen

Ponkilainen

Paloneva

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Literature describing the anatomic characteristics of osteochondral fractures (OCFs) in the knee joint after patellar dislocation is scarce. Purpose: To describe the patterns of OCFs in the knee joint after acute or recurrent patellar dislocation in a sample of patients from 2 orthopaedic trauma centers. Study Design: Case series; Level of evidence, 4. Methods: In this multicenter study, all patients who had International Classification of Diseases, 10th Revision, diagnostic codes S83.0 and M22.0 between 2012 and 2018 were screened. Of the 2181 patients with clinically diagnosed patellar dislocation, 1189 had undergone magnetic resonance imaging (MRI). Patients with diagnosed patellar dislocation and osteochondral fragment verified on MRI scans were included. Demographic and clinical data were collected from electronic patient records. OCF location and size were assessed from MRI scans. Results were further compared in subgroups by sex, skeletal maturity, and primary versus recurrent patellar dislocation. Results: An OCF was detected in 134 patients with injured knees, all of whom were included in the final analysis. It occurred in the patella in 63% of patients, in the lateral femoral condyle in 34%, and in both locations in 3%. The median OCF size was 146 mm2 (interquartile range, 105-262 mm2). There was no statistically significant difference in OCF size between patellar and lateral femoral condyle fractures. Patellar OCFs were more frequent in female than male patients ( P = .009) and were larger after primary than recurrent dislocation ( P = .040). Conclusion: OCFs were mainly located in the medial facet of the patella and in the lateral femoral condyle, with these locations accounting for approximately two-thirds and one-third of all OCFs, respectively. Proportion of patellar OCF was higher in female than in male. Patellar OCFs may be larger after primary than recurrent dislocation.

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“…20 Acutely, osteochondral and chondral fractures of the medial facet of the patella and/or the lateral femoral condyle can be a common finding on radiographs, MRI, ultrasound, arthroscopy, and open procedures (Figs 1-4). 5,12,16,18,23,38,46,49,52,55,56,64,65,67,68 The incidence of articular cartilage injuries and osteochondral fractures based on arthroscopy and open procedures is much more prevalent than found on initial radiographs. 42,49,64 Over the long term, acute patellar dislocations can result in patellar instability, pain, recurrent dislocations, decreased level of sporting activity, and patellofemoral arthritis.…”

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confidence: 99%

First-time Traumatic Patellar Dislocation

Stefancin

Parker²

2007

Clinical Orthopaedics and Related Research

429

364

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Acute patellar dislocations can result in patellar instability, pain, recurrent dislocations, decreased level of sporting activity, and patellofemoral arthritis. The initial management of a first-time traumatic patellar dislocation is controversial with no evidence-based consensus to guide decision making. Most first-time traumatic patellar dislocations have been traditionally treated nonoperatively; however, there has been a recent trend in initial surgical management. We performed a systematic review of Level I-IV studies to make evidence-based medicine recommendations on how a clinician should approach the diagnosis and treatment of a first-time traumatic dislocation. More specifically we answer the primary question of when initial treatment should consist of operative versus closed management. Based on the review of 70 articles looking at study design, mean followup, subjective and validated outcome measures, redislocation rates, and long-term symptoms, we recommend initial nonoperative management of a first-time traumatic dislocation except in several specific circumstances. These include the presence of an osteochondral fracture, substantial disruption of the medial patellar stabilizers, a laterally subluxated patella with normal alignment of the contralateral knee, or a second dislocation, or in patients not improving with appropriate rehabilitation.

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Sonographic Appearances of Medial Retinacular Complex Injury in Transient Patellar Dislocation

Cited by 30 publications

References 19 publications

Age-Related Differences in Medial Patellofemoral Ligament Injury Patterns in Traumatic Patellar Dislocation

Age-Related Differences in Medial Patellofemoral Ligament Injury Patterns in Traumatic Patellar Dislocation

Characteristics of Osteochondral Fractures Caused by Patellar Dislocation

First-time Traumatic Patellar Dislocation

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