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Acute patellar dislocation: how skeletal maturity affects patterns of injury

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Abstract

Objective

The main objective of this study was to understand the role of skeletal maturity in the different patterns of osteochondral and ligamentous injuries after an acute lateral patellar dislocation.

Materials and methods

Two radiologists independently reviewed MRIs of 212 knees performed after an acute lateral patellar dislocation to evaluate the presence of high-grade patellar osteochondral injury, femoral osteochondral injury, and medial patellofemoral ligament injury. The association of skeletal maturity (indicated by a closed distal femoral physis), age, sex, and first-time versus recurrent dislocation with each of these various lesions was analyzed using Chi-square or T test, and multivariable logistic regression with estimation of odds ratios (OR).

Results

Skeletal maturity was significantly associated with high-grade patellar osteochondral injury [OR=2.72 (95% CI 1.00, 7.36); p=0.049] and femoral-side MPFL tear [OR=2.34 (95% CI 1.05, 5.25); p=0.039]. Skeletal immaturity was significantly associated with patellar-side MPFL tear [OR=0.35 (95% CI 0.14, 0.90); p=0.029].

Conclusion

Patterns of injury to the patella and medial patellofemoral ligament vary notably between the skeletally immature and mature, and these variations may be explained by the inherent weakness of the patellar secondary physis.

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Authors and Affiliations

  1. Department of Radiology, Division of Musculoskeletal Imaging & Intervention, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA

    Sowmya L. Varada

  2. Department of Radiology, Division of Musculoskeletal Radiology, Columbia University Irving Medical Center, 622 West 168th Street, MC-28, New York, NY, 10032, USA

    Tony T. Wong

  3. Department of Orthopaedic Surgery, Center for Shoulder, Elbow and Sports Medicine & Pediatric Orthopedics, Columbia University Irving Medical Center, 3959 Broadway Avenue 8th Floor, New York, NY, 10032, USA

    Charles A. Popkin

  4. Department of Radiology, Division of Pediatric Radiology, Columbia University Irving Medical Center, 630 West 168th Street, MC-28, New York, NY, 10032, USA

    Diego Jaramillo

Authors
  1. Sowmya L. Varada
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  2. Tony T. Wong
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  4. Diego Jaramillo
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Correspondence to Sowmya L. Varada.

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Varada, S.L., Wong, T.T., Popkin, C.A. et al. Acute patellar dislocation: how skeletal maturity affects patterns of injury. Skeletal Radiol 53, 499–506 (2024). https://doi.org/10.1007/s00256-023-04446-w

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  • DOI: https://doi.org/10.1007/s00256-023-04446-w

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