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Prevalence and patterns of anatomical risk factors in patients after patellar dislocation: a case control study using MRI.
[trochlear dysplasia]
To
assess
anatomical
risk
factors
in
patients
after
lateral
patellar
dislocation
(
LPD
)
and
controls
using
MRI
.
MR
images
of
186
knees
after
LPD
and
of
186
age-
and
gender-matched
controls
were
analysed
.
The
presence
of
trochlear
dysplasia
was
assessed
by
evaluation
of
trochlear
inclination
,
facet
asymmetry
,
and
trochlear
depth
;
patella
alta
was
evaluated
by
the
Insall-
Salvati
index
and
Caton
-
Deschamps
index
;
the
lateralised
force
vector
was
measured
by
the
tibial
tuberosity-trochlear
groove
(
TT-
TG
)
distance
.
Compared
with
controls
,
dislocators
had
significantly
lower
values
for
all
three
parameters
of
trochlear
dysplasia
(
-
32
%
,
-
32
%
,
-
44
%
)
and
significantly
higher
values
for
patella
alta
(
+
14
%
,
+
13
%
)
and
TT-
TG
(
+
49
%
)
(
all
P
 
<
 
0
.
001
)
.
Trochlear
dysplasia
was
observed
in
112
dislocators
(
66
%
)
,
of
whom
61
(
36
%
)
additionally
had
patella
alta
and
15
(
9
%
)
an
abnormal
TT-
TG
.
As
isolated
risk
factors
,
patella
alta
(
15
%
)
and
abnormal
TT-
TG
(
1
%
)
were
rare
.
Only
25
dislocators
(
15
%
)
had
no
anatomical
risk
factors
.
Trochlear
dysplasia
in
conjunction
with
abnormal
TT-
TG
or
patella
alta
is
associated
with
a
37
-
and
41
-
fold
higher
risk
.
Most
dislocators
have
anatomical
risk
factors
,
varying
in
severity
and
constellation
.
