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Patellar dislocations in children, adolescents and adults: a comparative MRI study of medial patellofemoral ligament injury patterns and trochlear groove anatomy.
[trochlear dysplasia]
The
first
aim
was
to
compare
medial
patellofemoral
ligament
injury
patterns
in
children
and
adolescents
after
first
-time
lateral
patellar
dislocations
with
the
injury
patterns
in
adults
.
The
second
aim
was
to
evaluate
the
trochlear
groove
anatomy
at
different
developmental
stages
of
the
growing
knee
joint
.
Knee
magnetic
resonance
(
MR
)
images
were
collected
from
22
patients
after
first
-time
patellar
dislocations
.
The
patients
were
aged
14
.
2
years
(
a
range
of
11
-
15
years
)
.
The
injury
pattern
of
the
medial
patellofemoral
ligament
was
analysed
,
and
trochlear
dysplasia
was
evaluated
with
regard
to
sulcus
angle
,
trochlear
depth
and
trochlear
asymmetry
.
The
control
data
consisted
of
MR
images
from
21
adult
patients
who
were
treated
for
first
-time
lateral
patellar
dislocation
.
After
patellar
dislocation
,
injury
to
the
medial
patellofemoral
ligament
was
found
in
90
.
2
%
of
the
children
and
in
100
%
of
the
adult
patients
.
Injury
patterns
of
the
medial
patellofemoral
ligament
were
similar
between
the
study
group
and
the
control
group
with
regard
to
injury
at
the
patellar
attachment
site
(
Type
I
)
,
to
the
midsubstance
(
Type
II
)
and
to
injury
at
the
femoral
origin
(
Type
III
)
(
all
p
>
0
.
05
)
.
Combined
lesions
(
Type
IV
)
were
significantly
less
frequently
observed
in
adults
when
compared
to
the
study
group
(
p
=
0
.
02
)
.
The
magnitude
of
trochlear
dysplasia
was
similar
in
children
,
adolescents
and
adults
with
regard
to
all
three
of
the
measured
parameter-values
(
all
p
>
0
.
05
)
.
In
addition
,
the
articular
cartilage
had
a
significant
effect
on
the
distal
femur
geometry
in
both
paediatrics
and
adults
.
First
,
the
data
from
our
study
indicated
that
the
paediatric
medial
patellofemoral
ligament
injury
patterns
,
as
seen
on
MR
images
,
were
similar
to
those
in
adults
.
Second
,
the
trochlear
groove
anatomy
and
the
magnitude
of
trochlear
dysplasia
,
respectively
,
did
not
differ
between
adults
and
paediatrics
with
patellar
instability
.
Thus
,
physicians
are
confronted
with
similar
anatomical
risk
factors
and
similar
injuries
to
the
medial
soft
-tissue
restraints
in
children
when
compared
to
adults
with
patellar
instability
.
Diseases
Validation
Diseases presenting
"dislocations"
symptom
kabuki syndrome
trochlear dysplasia
This symptom has already been validated