Epidemiology and Natural History of Acute Patellar Dislocation

Fithian, Donald C.; Paxton, Elizabeth W.; Stone, Mary Lou; Silva, Patrı́cia; Davis, Daniel K.; Elias, Damian O.; White, Lawrence M.

doi:10.1177/0363546503260788

Cited by 987 publications

(918 citation statements)

References 57 publications

Supporting

Mentioning

844

Contrasting

Unclassified

Order By: Relevance

“…Lateral patellofemoral instability is a potentially disabling condition, with an incidence of 5.8 per 100,000, and is even more common in a younger population [9,11]. An increase in the TT-TG distance is one anatomic abnormality that may contribute to this condition [7,29].…”

Section: Introductionmentioning

confidence: 99%

Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Wilcox

Snow²,

Aoki

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background A lateralized tibial tubercle is one potential cause of patellar instability. The tibial tubercle-trochlear groove (TT-TG) distance using CT is a reliable measure and considered the gold standard. Using MRI for this purpose has increased, although the reliability of doing so is not well studied. Questions/purposes We sought to (1) determine variability in the insertion of the patellar tendon relative to the tibial tubercle and whether this affects the measurement on MRI of the traditional TT-TG distance versus the functional patellar tendon-trochlear groove (PT-TG) distance, (2) determine the reliability of measuring the osseous TT-TG distance, (3) determine the reliability of measuring the soft tissue PT-TG distance, and (4) compare the reliabilities of using osseous (TT-TG) versus soft tissue (PT-TG) landmarks. Methods Four observers measured the TT-TG and the PT-TG distances of 50 MR images of knees obtained for any reason. Each observer repeated these measurements 30 days later. The interobserver and intraobserver reliabilities, measurements per observer that varied from the group mean by greater than 2 mm, and the limit of agreement were calculated. Results The TT-TG and PT-TG differed by as little as 0.11 mm and by as much as 4.18 mm with an average difference of 1.37 mm. The interobserver and intraobserver reliabilities were greater than 90% for the PT-TG and TT-TG distances. The PT-TG distance was less variable in that this measurement showed interobserver and intraobserver reliabilities of 0.977 and 0.972 respectively, versus 0.913 and 0.961 for the TT-TG measurement. Additionally, the PT-TG measurements resulted in a lower average difference to the mean for each observer, less number of knees per observer where the difference to the mean was greater than 2 mm, and improved limit of agreement. Conclusions The TT-TG and the PT-TG distances were not identical and differed by as much as 4.18 mm; as such they are not interchangeable when measuring this distance.

show abstract

Section: Introductionmentioning

confidence: 99%

Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Wilcox

Snow²,

Aoki

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Acute patellar dislocation accounts for 2-3% of acute knee injuries, with the highest incidence being in adolescence [1,2]. Apart from the traumatic component, the presence of predisposing morphological and functional patellofemoral disorders [3,4] is of equal importance.…”

Section: Introductionmentioning

confidence: 99%

Acute patellar dislocation in adolescents: operative versus nonoperative treatment

Apostolović

Vukomanović

Slavković

et al. 2011

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose The purpose of this prospective non-randomised study was to compare the efficacy of two opposed methods, operative and conservative. Our hypothesis was that if the method was selected correctly, on an individual basis, the results should be approximately equal. Methods The study included 37 adolescents aged between 12 and 16 years, with a mean follow up of 6.1 years. The presence of a significant loose body, confirmed by precise imaging, was the key for selecting operative or arthroscopic treatment. In both groups of patients, we evaluated functional knee scores and the incidence of residual patellofemoral disorders.Results We confirmed our hypothesis using the t-test to compare functional results and a test for comparison of proportions for incidence of residual disorders. There was no statistically significant difference (p=0.091) between operatively and conservatively treated groups with regard to functional results. The same statistical outcome emerged when comparing incidences of re-dislocation (p=0.854), or other major patellar instabilities (p=0.856), between the groups. Conclusions The results obtained should not promote a non-operative method on the basis of lower risk, but do support an individual approach based on precise diagnosis and defined criteria.

show abstract

“…Statistical studies demonstrate incidence of 5.8 per 100,000 inhabitants and this number increases to 29 per 100,000 inhabitants between 10 years and 17 years of age (11,12) . Hsiao et al (8) observed higher incidence of this injury in military privates, who attributed the intrinsic physical fitness of this group and the character of their activities, which make the risks of musculo-skeletal injuries increase, condition which we consider comparable to professional athletes.…”

Section: Discussionmentioning

confidence: 96%

Importância do ligamento femoropatelar medial no deslocamento e na inclinação lateral da patela: estudo radiográfico em cadáveres

Fávaro

Severino²,

Fávaro

et al. 2011

Rev Bras Med Esporte

View full text Add to dashboard Cite

Objective: Acute patellar luxation is a complex disease that mainly affects young patients. Its physiopathology is little known and the understanding of it and its therapeutic conduct are controversial. The medial patellofemoral ligament (MPFL) is the main static stabilizer for preventing lateral displacement of the patella. In order to assess the stability of the patellofemoral joint, the authors radiographically assessed the presence, or absence of lateral displacement and inclination of the patella before and after the MPFL section in the knees of cadavers. Methods: Thirty knees of cadavers were radiographed on the axial incidence of the patella by means of the technique described by Merchant before and after MPFL section. The Merchant congruence angle and Laurin lateral patellofemoral angle were measured. Results: The medial patellofemoral ligament presented mean length of 4.8cm, and width of 1.6 cm. In six anatomical pieces there was no change in the Laurin lateral patellofemoral angle (20%), in three anatomical pieces the change was one degree (10%), in 20 (67%) two degrees and in one anatomical piece it was four degrees (3%). Changes occurred between zero and two degrees in 97% of the knees of cadavers. In six anatomical pieces there was no change in the Merchant congruence angle (17%); in six anatomical pieces the change was one degree (20%), in 17 (57%) two degrees, in one anatomical piece it was three degrees (3%) and in one it was six degrees (3%). These changes occurred between zero and two degrees in 93% of the knees of cadavers. Conclusion: Analysis of the results obtained in this study allowed us to conclude that the medial patellofemoral ligament is important in the lateral inclination and displacement of the patella with knee flexed at 45º.

show abstract

Epidemiology and Natural History of Acute Patellar Dislocation

Cited by 987 publications

References 57 publications

Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Acute patellar dislocation in adolescents: operative versus nonoperative treatment

Importância do ligamento femoropatelar medial no deslocamento e na inclinação lateral da patela: estudo radiográfico em cadáveres

Contact Info

Product

Resources

About