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Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella

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Abstract

Objectives

To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children.

Methods

MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols.

Results

Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543).

Conclusions

MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion.

Key Points

• MPFL is most easily injured at its patellar insertion in children.

• Wiberg patellar type B predisposes to complete MPFL tear.

• No correlations between injury patterns of MPFL and other three anatomical variants.

• Complete MPFL tear predisposes to higher grade patellar chondral lesion.

• No correlations between injury locations of MPFL and patellar cartilage lesion.

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Acknowledgments

The scientific guarantor of this publication is Hong-yu Ding. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding.

No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported before. Methodology: prospective, cross-sectional study, performed at one institution.

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Authors and Affiliations

  1. Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University, 16766 Jingshi Rd, Li-Xia District, 250014, Jinan, China

    Guang-ying Zhang & Hong-yu Ding

  2. Department of Radiology, Shandong Provincial Corps Hospital of Chinese People’s Armed Police Force, Jinan, 250014, China

    Lei Zheng & Bing-jun Ji

  3. Department of Radiology, Shandong Provincial Qianfoshan Hospital of Shandong University, Jinan, 250014, China

    Hao Shi

  4. Department of Radiology, Affiliated Hospital of Binzhou Medical College, Binzhou, 256603, China

    Yan Feng

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  1. Guang-ying Zhang
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  2. Lei Zheng
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  3. Hao Shi
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  5. Yan Feng
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Correspondence to Hong-yu Ding.

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Zhang, Gy., Zheng, L., Shi, H. et al. Injury patterns of medial patellofemoral ligament after acute lateral patellar dislocation in children: Correlation analysis with anatomical variants and articular cartilage lesion of the patella. Eur Radiol 27, 1322–1330 (2017). https://doi.org/10.1007/s00330-016-4473-5

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  • DOI: https://doi.org/10.1007/s00330-016-4473-5

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