Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 7 , Pages 926-935 , July 2010

Magnetic Resonance Imaging Characteristics of the Medial Patellofemoral Ligament Lesion in Acute Lateral Patellar Dislocations Considering Trochlear Dysplasia, Patella Alta, and Tibial Tuberosity–Trochlear Groove Distance

  • Peter Balcarek, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • Arthroscopic Section, German Society of Trauma Surgery, Hannover, Germany
    • Corresponding Author InformationAddress correspondence and reprint requests to Peter Balcarek, M.D., Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
    • ,
  • Jan Ammon, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • ,
  • Stephan Frosch, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • Arthroscopic Section, German Society of Trauma Surgery, Hannover, Germany
    • ,
  • Tim A. Walde, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • Arthroscopic Section, German Society of Trauma Surgery, Hannover, Germany
    • ,
  • Jan P. Schüttrumpf, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • Arthroscopic Section, German Society of Trauma Surgery, Hannover, Germany
    • ,
  • Keno G. Ferlemann, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • ,
  • Helmut Lill, M.D.

      Affiliations

    • Arthroscopic Section, German Society of Trauma Surgery, Hannover, Germany
    • Department of Trauma and Reconstructive Surgery, Diakoniekrankenhaus Friederikenstift, Hannover, Germany
    • ,
  • Klaus M. Stürmer, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • ,
  • Karl-Heinz Frosch, M.D.

      Affiliations

    • Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany
    • Arthroscopic Section, German Society of Trauma Surgery, Hannover, Germany

Received 3 May 2009 ,Accepted 9 November 2009.

References 

  1. Arendt EA, Fithian DC, Cohen E. Current concepts of lateral patella dislocation. Clin Sports Med. 2002;21:499–519
  2. Senavongse W, Amis AA. The effects of articular, retinacular or muscular deficiencies on patellofemoral joint stability: A biomechanical study in vitro. J Bone Joint Surg Br. 2005;87:577–582
  3. Fulkerson JP, Post WR. Disorders of the patellofemoral joint. Ed 3. Baltimore: Williams & Williams; 1997;
  4. Amis AA, Senavongse W, Bull AM. Patellofemoral kinematics during knee flexion-extension: An in vitro study. J Orthop Res. 2006;24:2201–2211
  5. Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. Transient lateral patellar dislocation: Diagnosis with MR imaging. AJR Am J Roentgenol. 1993;161:109–113
  6. Fucentese SF, von Roll A, Koch PP, Epari DR, Fuchs B, Schottle PB. The patella morphology in trochlear dysplasia—A comparative MRI study. Knee. 2006;13:145–150
  7. Schoettle PB, Zanetti M, Seifert B, Pfirrmann CW, Fucentese SF, Romero J. The tibial tuberosity-trochlear groove distance; a comparative study between CT and MRI scanning. Knee. 2006;13:26–31
  8. Spritzer CE, Courneya DL, Burk DL, Garrett WE, Strong JA. Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. AJR Am J Roentgenol. 1997;168:117–122
  9. Desio SM, Burks RT, Bachus KN. Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med. 1998;26:59–65
  10. Elias DA, White LM, Fithian DC. Acute lateral patellar dislocation at MR imaging: Injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Radiology. 2002;225:736–743
  11. Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG. Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr. 2001;25:957–962
  12. Nomura E, Horiuchi Y, Inoue M. Correlation of MR imaging findings and open exploration of medial patellofemoral ligament injuries in acute patellar dislocations. Knee. 2002;9:139–143
  13. Nomura E. Classification of lesions of the medial patello-femoral ligament in patellar dislocation. Int Orthop. 1999;23:260–263
  14. Lance E, Deutsch AL, Mink JH. Prior lateral patellar dislocation: MR imaging findings. Radiology. 1993;189:905–907
  15. Quinn SF, Rose PM, Brown TR, Demlow TA. MR imaging of the patellofemoral compartment. Magn Reson Imaging Clin N Am. 1994;2:425–440
  16. Virolainen H, Visuri T, Kuusela T. Acute dislocation of the patella: MR findings. Radiology. 1993;189:243–246
  17. Sillanpää PJ, Peltola E, Mattila VM, Kiuru M, Visuri T, Pihlajamäki H. Femoral avulsion of the medial patellofemoral ligament after primary traumatic patellar dislocation predicts subsequent instability in men: A mean 7-year nonoperative follow-up study. Am J Sports Med. 2009;37:1513–1521
  18. Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP. Anatomy and biomechanics of the medial patellofemoral ligament. Knee. 2003;10:215–220
  19. Dejour D, Reynaud P, Lecoultre B. Douleurs et instabilite rotulienne (Essai de classification). Med Hyg (Geneve). 1998;56:1466–1471
  20. Pfirrmann CW, Zanetti M, Romero J, Hodler J. Femoral trochlear dysplasia: MR findings. Radiology. 2000;216:858–864
  21. Senavongse W, Farahmand F, Jones J, Andersen H, Bull AM, Amis AA. Quantitative measurement of patellofemoral joint stability: Force-displacement behavior of the human patella in vitro. J Orthop Res. 2003;21:780–786
  22. Christiansen SE, Jakobsen BW, Lund B, Lind M. Isolated repair of the medial patellofemoral ligament in primary dislocation of the patella: A prospective randomized study. Arthroscopy. 2008;24:881–887
  23. Ahmad CS, Stein BE, Matuz D, Henry JH. Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation (A review of eight cases). Am J Sports Med. 2000;28:804–810
  24. Sallay PI, Poggi J, Speer KP, Garrett WE. Acute dislocation of the patella (A correlative pathoanatomic study). Am J Sports Med. 1996;24:52–60
  25. Nikku R, Nietosvaara Y, Kallio PE, Aalto K, Michelsson JE. Operative versus closed treatment of primary dislocation of the patella (Similar 2-year results in 125 randomized patients). Acta Orthop Scand. 1997;68:419–423
  26. Mountney J, Senavongse W, Amis AA, Thomas NP. Tensile strength of the medial patellofemoral ligament before and after repair or reconstruction. J Bone Joint Surg Br. 2005;87:36–40
  27. Miller TT, Staron RB, Feldman F. Patellar height on sagittal MR imaging of the knee. AJR Am J Roentgenol. 1996;167:339–341
  28. Alemparte J, Ekdahl M, Burnier L, et al. Patellofemoral evaluation with radiographs and computed tomography scans in 60 knees of asymptomatic subjects. Arthroscopy. 2007;23:170–177
  29. Amis AA, Farahmand F. Biomechanics masterclass: Extensor mechanism of the knee. Curr Orthop. 1996;10:102–109
  30. Shih Y-F, Bull AMJ, Amis AA. The cartilaginous and osseous geometry of the femoral trochlear groove. Knee Surg Sports Traumatol Arthrosc. 2004;12:300–306
  31. Eckhoff DG, Burke BJ, Dwyer TF, Pring ME, Spitzer VM, VanGerwen DP. Sulcus morphology of the distal femur. Clin Orthop Relat Res. 1996;23–28
  32. Bicos J, Carofino B, Andersen M, Schepsis AA, Fulkerson JP, Mazzocca A. Patellofemoral forces after medial patellofemoral ligament reconstruction: A biomechanical analysis. J Knee Surg. 2006;19:317–326
  33. Ostermeier S, Stukenborg-Colsman C, Hurschler C, Wirth CJ. In vitro investigation of the effect of medial patellofemoral ligament reconstruction and medial tibial tuberosity transfer on lateral patellar stability. Arthroscopy. 2006;22:308–319

 The authors report no conflict of interest.

PII: S0749-8063(09)00948-7

doi: 10.1016/j.arthro.2009.11.004

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 7 , Pages 926-935 , July 2010

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