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Correlation analysis between injury patterns of medial patellofemoral ligament and vastus medialis obliquus after acute first-time lateral patellar dislocation

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate the correlation between injury patterns of the medial patellofemoral ligament (MPFL) and vastus medialis obliquus (VMO) after acute first-time lateral patellar dislocation (LPD) in adults.

Methods

Magnetic resonance imaging (MRI) was prospectively performed in 132 consecutive adults with acute first-time LPD. Images were acquired and evaluated using standardized protocols. Injury patterns of MPFL were grouped by location and severity for analysis of the prevalence of VMO injury.

Results

MRI demonstrated VMO injury in 63 (47.7%) patients. Twenty (38.5%) and 43 cases (56.6%) were present in partial and complete MPFL tear subgroups, respectively. Compared with partial MPFL tears, complete tears showed a higher prevalence of VMO injury (P = 0.044). The mean coronal (28.5 mm) and mean sagittal VMO elevations (20.7 mm) were higher in the complete MPFL tear subgroup than in the partial tear subgroup (19.8 mm, P = 0.005; 11.9 mm, P < 0.001). No correlations were identified between the prevalence of VMO injury and location subgroups of MPFL injury (n.s.). Mean VMO elevations were higher in isolated femoral-side (FEM) and combined MPFL tear (COM) subgroups (mean coronal VMO elevation of 29 mm and mean sagittal VMO elevation of 20.8 mm in the FEM subgroup; mean coronal VMO elevation of 29.6 mm and mean sagittal VMO elevation of 23.1 mm in the COM subgroup) than in the isolated patellar-side MPFL tear (PAT) subgroup (P = 0.022, P < 0.001) (mean coronal VMO elevation of 20.7 mm and mean sagittal VMO elevation of 10.6 mm).

Conclusions

Complete MPFL tear predisposes to VMO injury and has a higher elevation of torn VMO after acute first-time LPD in adults. Isolated femoral-side and combined MPFL tears predispose to higher elevation of torn VMO.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University, 16766 Jingshi Rd, Li-Xia District, Jinan, 250014, China

    Guang-ying Zhang, Wei Liu, Li Zhang, Su-hui Qu & Hong-yu Ding

  2. Department of Radiology, Shandong Provincial Corps Hospital of Chinese People’s Armed Police Force, Jinan, 250014, China

    Lei Zheng

  3. Department of Radiology, Shandong Provincial Qianfoshan Hospital of Shandong University, Jinan, 250014, China

    Hao Shi

  4. Department of Orthopedics, Shandong Provincial Qianfoshan Hospital of Shandong University, Jinan, 250014, China

    Zheng-wu Bai

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  1. Guang-ying Zhang
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  4. Wei Liu
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  5. Li Zhang
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Corresponding author

Correspondence to Hong-yu Ding.

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Conflict of interest

All authors (Zhang Guang-ying, Zheng Lei, Shi Hao, Liu Wei, Zhang Li, Qu Su-hui, Bai Zhengwu, Ding Hong-yu) declare that they have no financial and/or personal relationships with other individuals or organizations that could influence this work.

Funding

No funding was received in support of this manuscript.

Ethical approval

The study was authorized by the local ethics committee and was performed in accordance with the Ethical standards of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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The authors state that the patients gave the informed consent prior being included into the study.

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Zhang, Gy., Zheng, L., Shi, H. et al. Correlation analysis between injury patterns of medial patellofemoral ligament and vastus medialis obliquus after acute first-time lateral patellar dislocation. Knee Surg Sports Traumatol Arthrosc 26, 719–726 (2018). https://doi.org/10.1007/s00167-016-4408-3

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