Articular Cartilage Damage Worsens from First-time to Recurrent Patellar Dislocation-A Longitudinal Magnetic...

Area of Science:

• Orthopedic surgery
• Radiology
• Sports medicine

Background:

• Patellar dislocations can lead to articular cartilage injury.
• Recurrent dislocations may exacerbate cartilage damage.
• Longitudinal assessment of cartilage injury is crucial for understanding disease progression.

Purpose of the Study:

• To compare the frequency and severity of articular cartilage injury on longitudinal magnetic resonance imaging (MRI) in patients after their initial dislocation versus subsequent recurrent dislocations.
• To evaluate the impact of recurrent patellar instability on articular cartilage damage progression.

Main Methods:

• Retrospective review of 35 patients undergoing patellar stabilization surgery between 2012 and 2017.
• Inclusion criteria: MRI scans available after both initial and subsequent dislocation events.
• Blind examination of MRI scans to assess Outerbridge classification grade of articular cartilage injury and location.

Main Results:

• Incidence of articular cartilage injury increased from 45.7% after initial dislocation to 62.9% after recurrent dislocation (P=.031).
• Among patients with initial injury, 56.2% showed an increased injury grade after the second dislocation.
• 17.1% of patients developed new articular cartilage injury after their second dislocation.

Conclusions:

• Articular cartilage injury is a frequent consequence of patellar dislocation.
• Delayed surgical treatment for patellar instability may lead to increased articular cartilage damage.
• Recurrent patellar dislocations are associated with a high incidence and progression of articular cartilage injury, as evidenced by MRI findings.