Analysis of Cartilage Injury Patterns and Risk Factors for Knee Joint Damage in Patients with Primary Lateral Patella Dislocations

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 Oct 14

PMID 34648534

Citations 6

Authors

Yannick Palmowski

Tobias Jung

Anne-Katrin Doering

Clemens Gwinner

Imke Schatka

Benjamin Bartek

Affiliations

Soon will be listed here.

Abstract

Background: Lateral patellar dislocation (LPD) frequently causes damage to the knee. Injury patterns and risk factors contributing to such injuries have not yet been examined in detail.

Methods: We retrospectively analyzed 50 consecutive patients with primary LPD. Two reviewers evaluated the MRI images regarding risk factors for LPD (Dejours classification; Caton-Deschamps Index, CDI; distance from the tibial tuberosity to trochlear groove, TT-TG; trochlear depth, TD) as well as joint damages according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS).

Results: 33 male and 17 female patients with a mean age of 23.2 (±9.6) years were included in this study. 52% were classified Dejours ≥ B, 34% had a CDI ≥ 1.3, 22% a TT-TG ≥ 20mm and 52% a TD < 3mm. 49 out of 50 patients (98%) showed abnormalities according to WORMS. The most frequently observed abnormalities were synovitis/effusion (49/50, 98%), bone marrow oedema (44/50, 88%) and cartilage damage (42/50, 84%). Most frequently affected subregions were medial (41/50, 82%) and lateral (31/50, 62%) patella as well as the anterior (43/50, 86%), central (42/50, 84%) and posterior (11/50, 22%) portion of the lateral femoral condyle. There was no significant correlation between any of the examined risk factors and joint damages according to WORMS. Male patients had higher scores regarding total cartilage damage (5.11 vs. 2.56, p = 0.029), total score for the lateral femorotibial joint (3.15 vs. 1.65, p = 0.026) and overall total WORMS score (12.15 vs. 8.29, p = 0.038).

Conclusion: Risk factors for LPD do not influence the risk of damages to the knee joint after primary LPD. Although LPD is generally known to affect more female than male patients, male patients suffered more severe injuries after primary LPD, particularly of the lateral femorotibial joint. Overall, our results underline the importance of MRI imaging after primary LPD.

Citing Articles

Prevalence and Site of Concomitant Osteochondral Injuries in Patients With Acute Lateral Patellar Dislocation: A Systematic Review and Meta-analysis.

Yi Z, Jiang J, Liu J, Ma M, Chen Y, Teng F Orthop J Sports Med. 2024; 12(1):23259671231220904.

PMID: 38274015 PMC: 10809874. DOI: 10.1177/23259671231220904.

Epidemiology of Lateral Patellar Dislocation Including Bone Bruise Incidence: Five Years of Data from a Trauma Center.

Dai R, Wu Y, Jiang Y, Huang H, Meng Q, Shi W Orthop Surg. 2024; 16(2):437-443.

PMID: 38214094 PMC: 10834195. DOI: 10.1111/os.13933.

Factors associated with an increased risk of osteochondral injuries after patellar dislocations: a systematic review.

Yi Z, Zhang X, Wu M, Jiang J, Xia Y J Orthop Surg Res. 2023; 18(1):822.

PMID: 37915023 PMC: 10621231. DOI: 10.1186/s13018-023-04265-8.

Patterns of Associated Knee Ligament and Chondral Injuries in First-Time Traumatic Patellar Dislocation: A Retrospective Magnetic Resonance Imaging (MRI) -Based Study.

Anazor F, Evangelou K Cureus. 2022; 14(11):e31850.

PMID: 36579225 PMC: 9792303. DOI: 10.7759/cureus.31850.

Magnetic resonance imaging is able to detect patellofemoral focal cartilage injuries: a systematic review with meta-analysis.

Xara-Leite F, Vinha A, Valente C, Andrade R, Espregueira-Mendes J Knee Surg Sports Traumatol Arthrosc. 2022; 31(6):2469-2481.

PMID: 36266368 DOI: 10.1007/s00167-022-07203-z.

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