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Medial patellofemoral ligament anatomy: is it a predisposing factor for lateral patellar dislocation?
[trochlear dysplasia]
Because
the
medial
patellofemoral
ligament
(
MPFL
)
is
the
primary
restraint
to
lateral
dislocation
of
the
patella
,
we
aimed
,
in
this
controlled
study
,
to
verify
whether
the
MPFL
with
different
measurements
could
be
considered
another
predisposing
factor
for
patellar
dislocation
.
A
group
of
100
consecutive
individuals
without
the
criteria
for
patellar
dislocation
(
trochlear
dysplasia
,
patella
alta
and
lateral
patellar
tilt
)
was
recruited
as
a
control
group
and
underwent
magnetic
resonance
imaging
(
MRI
)
study
and
another
group
of
50
patients
with
patellar
instability
.
Femoral
condyles
,
interepicondylar
distance
,
length
and
thickness
of
the
MPFL
were
measured
.
In
the
control
group
,
the
MPFL
was
38
-
60
mm
long
.
Individuals
with
patellar
instability
who
had
no
episode
of
patellar
dislocation
had
a
4
.
11
-
mm
longer
ligament
than
controls
(
p
 
=
 
0
.
032
)
,
while
patients
with
instability
with
a
previous
history
of
dislocation
had
a
13
.
54
-
mm
longer
MPFL
than
controls
(
p
 
<
 
0
.
001
)
.
Thickness
of
the
MPFL
at
the
patellar
insertion
was
lower
in
individuals
with
patellar
instability
with
a
history
of
dislocation
(
p
 
<
 
0
.
001
)
.
An
instability
coefficient
(
IC
)
less
than
1
.
3
indicates
that
the
MPFL
is
insufficient
.
Individuals
with
patellar
instability
and
previous
patellar
dislocation
present
with
longer
MPFL
when
compared
to
controls
,
and
an
associated
IC
less
than
1
.
3
can
be
considered
a
predisposing
factor
for
patellar
dislocation
.
Treatment
of
patellar
instability
is
a
challenge
,
and
it
is
difficult
to
identify
what
is
the
predisposing
factor
.
This
study
has
verified
the
measurements
of
the
MPFL
for
the
first
time
and
presents
values
of
thickness
and
length
that
can
be
considered
as
indications
for
surgical
reconstruction
.
III
.
Diseases
Validation
Diseases presenting
"femoral condyles"
symptom
trochlear dysplasia
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