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Acute patellar dislocation: how skeletal maturity affects patterns of injury
Sowmya L Varada1, Tony T Wong2, Charles A Popkin3
1Department of Radiology, Division of Musculoskeletal Imaging & Intervention, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA. svarada@mgh.harvard.edu.
Skeletal maturity influences injury patterns in acute lateral patellar dislocations. Immature knees show higher rates of patellar tears, while mature knees have more femoral-sided injuries, linked to physeal weakness.
Area of Science:
- Orthopedic Surgery
- Radiology
- Sports Medicine
Background:
- Acute lateral patellar dislocation is a common injury.
- Understanding injury patterns is crucial for effective treatment.
- Skeletal maturity may influence injury characteristics.
Purpose of the Study:
- To investigate the role of skeletal maturity in osteochondral and ligamentous injuries following acute lateral patellar dislocation.
- To analyze variations in injury patterns between skeletally immature and mature individuals.
Main Methods:
- Retrospective review of 212 knee MRIs after acute lateral patellar dislocation.
- Independent assessment of patellar and femoral osteochondral injuries, and medial patellofemoral ligament (MPFL) injuries by two radiologists.
- Statistical analysis using Chi-square/T test and multivariable logistic regression to correlate skeletal maturity with injury types.
Main Results:
- Skeletal maturity was associated with high-grade patellar osteochondral injury (OR=2.72) and femoral-side MPFL tears (OR=2.34).
- Skeletal immaturity showed a significant association with patellar-side MPFL tears (OR=0.35).
Conclusions:
- Injury patterns of the patella and MPFL differ significantly between skeletally immature and mature patients.
- These variations are likely due to the inherent vulnerability of the patellar secondary physis in immature individuals.
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