Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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The Correlation between the Injury Patterns of the Medial Patellofemoral Ligament in an Acute First-Time Lateral Patellar Dislocation on MR Imaging and the Incidence of a Second-Time Lateral Patellar Dislocation

  • Zhang, Guang-ying (Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University) ;
  • Zhu, Hong-xia (Department of Ultrasonography, The Second People's Hospital of Liaocheng) ;
  • Li, En-miao (Department of Ultrasonography, Jinan Third People's Hospital) ;
  • Shi, Hao (Department of Radiology, Shandong Provincial Qianfoshan Hospital of Shandong University) ;
  • Liu, Wei (Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University) ;
  • Zheng, Lei (Department of Radiology, Shandong Provincial Corps Hospital of Chinese People's Armed Police Force) ;
  • Bai, Zheng-wu (Department of Orthopedics, Shandong Provincial Qianfoshan Hospital of Shandong University) ;
  • Ding, Hong-yu (Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University)
  • Received : 2017.05.27
  • Accepted : 2017.08.10
  • Published : 2018.04.01
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Abstract

Objective: To evaluate the correlation between the injury patterns of the medial patellofemoral ligament (MPFL) on magnetic resonance imaging in an acute first-time lateral patellar dislocation (LPD) and incidence of a second-time LPD. Materials and Methods: Magnetic resonance images were prospectively analyzed in 147 patients after an acute first-time LPD with identical nonoperative management. The injury patterns of MPFL in acute first-time LPDs were grouped by location and severity for the analysis of the incidence of second-time LPD in a 5-year follow-up. Independent t tests, chi-square tests and Kruskal-Wallis tests were performed as appropriate. Results: Forty-six cases (46/147, 31.3%) of second-time LPD were present at the 5-year follow-up. Fourteen (14/62, 22.6%) and 31 cases (31/80, 38.8%) were present in the partial and complete MPFL tear subgroups, respectively. Twenty-five cases (25/65, 38.5%), 11 cases (11/26, 42.3%), and 8 cases (8/47, 17%) were present in the isolated femoral-side MPFL tear (FEM), combined MPFL tear (COM), and isolated patellar-side MPFL tear (PAT) subgroups, respectively. Compared with the partial MPFL tears, complete tears showed higher incidence of a second-time LPD (p = 0.04). The time interval between the two LPDs was shorter in the complete MPFL tear subgroup (24.2 months) than in the partial tear subgroup (36.9 months, p = 0.001). Compared with the PAT subgroup, the FEM and COM subgroups showed a higher incidence of a second-time LPD (p = 0.025). The time intervals between the two LPDs were shorter in the FEM and COM subgroups (20.8 months and 19.2 months) than in the PAT subgroup (32.5 months, p = 0.049). Conclusion: A complete MPFL tear, isolated femoral-side tear and combined tear in a first-time LPD predispose a second-time LPD.

Keywords

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