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Radiologic Criteria in Patellar Dislocations

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Sports Injuries

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Abstract

Imaging of patellofemoral instability allows the recognition of the disturbances of shape and congruence leading to dislocations. The key to adequate imaging is complete evaluation of the underlying factors leading to instability. This chapter discusses the radiographic signs of these factors involved in the genesis of instability, which are trochlear dysplasia, patella alta, abnormal tibial tuberosity-trochlear groove distance, and lateral patellar tilt. Additionally, the acute signs of patellar dislocation are reviewed.

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References

  • Balcarek P, Ammon J, Frosch S et al (2010) Magnetic resonance imaging characteristics of the medial patellofemoral ligament lesion in acute lateral patellar dislocations considering trochlear dysplasia, patella alta, and tibial tuberosity–trochlear groove distance. Arthroscopy 26:926–935. doi:10.1016/j.arthro.2009.11.004

    Article  PubMed  Google Scholar 

  • Balcarek P, Walde TA, Frosch S et al (2011) MRI but not arthroscopy accurately diagnoses femoral MPFL injury in first-time patellar dislocations. Knee Surg Sports Traumatol Arthrosc 20:1575–1580. doi:10.1007/s00167-011-1775-7

    Article  PubMed Central  PubMed  Google Scholar 

  • Bernageau J, Goutallier D, Debeyre J, Ferrané J (1975) New exploration technic of the patellofemoral joint. Relaxed axial quadriceps and contracted quadriceps. Rev Chir Orthop Réparatrice Appar Mot 61(Suppl 2):286–290

    PubMed  Google Scholar 

  • Biedert RM, Albrecht S (2006) The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 14:707–712. doi:10.1007/s00167-005-0015-4

    Article  Google Scholar 

  • Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Joint Surg (Br) 59:241–242

    CAS  Google Scholar 

  • Brattstroem H (1964) Shape of the intercondylar groove normally and in recurrent dislocation of patella. A clinical and x-ray-anatomical investigation. Acta Orthop Scand Suppl 68(Suppl 68):1–148

    PubMed  Google Scholar 

  • Brossmann J, Muhle C, Büll CC et al (1994) Evaluation of patellar tracking in patients with suspected patellar malalignment: cine MR imaging vs arthroscopy. AJR Am J Roentgenol 162:361–367

    Article  CAS  PubMed  Google Scholar 

  • Carrillon Y, Abidi H, Dejour D et al (2000) Patellar instability: assessment on MR images by measuring the lateral trochlear inclination-initial experience. Radiology 216:582–585

    Article  CAS  PubMed  Google Scholar 

  • Caton J (1989) Method of measuring the height of the patella. Acta Orthop Belg 55:385–386

    CAS  PubMed  Google Scholar 

  • Caton J, Deschamps G, Chambat P et al (1982) Patella infera. Apropos of 128 cases. Rev Chir Orthop Réparatrice Appar Mot 68:317–325

    CAS  PubMed  Google Scholar 

  • DeJour D, Saggin P (2010) The sulcus deepening trochleoplasty—the Lyon’s procedure. Int Orthop 34:311–316. doi:10.1007/s00264-009-0933-8

    Article  PubMed Central  PubMed  Google Scholar 

  • Dejour H, Walch G, Nove-Josserand L, Guier C (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 2:19–26

    Article  CAS  Google Scholar 

  • Dejour D, Reynaud P, Lecoultre B (1998) Douleurs et Instabilité Rotulienne, Essai de Classification. Méd Hyg 56:1466–1471

    Google Scholar 

  • Delgado-Martins H (1979) A study of the position of the patella using computerised tomography. J Bone Joint Surg (Br) 61-B:443–444

    CAS  Google Scholar 

  • Diederichs G, Issever AS, Scheffler S (2010) MR imaging of patellar instability: injury patterns and assessment of risk factors. Radiogr Rev Publ Radiol Soc N Am Inc 30:961–981. doi:10.1148/rg.304095755

    Google Scholar 

  • Diederichs G, Köhlitz T, Kornaropoulos E et al (2013) Magnetic resonance imaging analysis of rotational alignment in patients with patellar dislocations. Am J Sports Med 41:51–57. doi:10.1177/0363546512464691

    Article  PubMed  Google Scholar 

  • Dietrich TJ, Betz M, Pfirrmann CWA et al (2012) End-stage extension of the knee and its influence on tibial tuberosity-trochlear groove distance (TTTG) in asymptomatic volunteers. Knee Surg Sports Traumatol Arthrosc Off J ESSKA. doi:10.1007/s00167-012-2357-z

    Google Scholar 

  • Elias DA, White LM, Fithian DC (2002) Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Radiology 225:736–743

    Article  PubMed  Google Scholar 

  • Goutallier D, Bernageau J, Lecudonnec B (1978) The measurement of the tibial tuberosity. Patella groove distanced technique and results (author’s transl). Rev Chir Orthop Réparatrice Appar Mot 64:423–428

    CAS  PubMed  Google Scholar 

  • Grelsamer RP, Weinstein CH, Gould J, Dubey A (2008) Patellar tilt: the physical examination correlates with MR imaging. Knee 15:3–8. doi:10.1016/j.knee.2007.08.010

    Article  PubMed  Google Scholar 

  • Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101:101–104

    CAS  PubMed  Google Scholar 

  • Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF (1993) Transient lateral patellar dislocation: diagnosis with MR imaging. AJR Am J Roentgenol 161:109–113

    Article  CAS  PubMed  Google Scholar 

  • Kujala UM, Osterman K, Kormano M et al (1989) Patellar motion analyzed by magnetic resonance imaging. Acta Orthop Scand 60:13–16

    Article  CAS  PubMed  Google Scholar 

  • Lance E, Deutsch AL, Mink JH (1993) Prior lateral patellar dislocation: MR imaging findings. Radiology 189:905–907

    CAS  PubMed  Google Scholar 

  • Laurin CA, Lévesque HP, Dussault R et al (1978) The abnormal lateral patellofemoral angle: a diagnostic roentgenographic sign of recurrent patellar subluxation. J Bone Joint Surg Am 60:55–60

    CAS  PubMed  Google Scholar 

  • Laurin CA, Dussault R, Levesque HP (1979) The tangential x-ray investigation of the patellofemoral joint: x-ray technique, diagnostic criteria and their interpretation. Clin Orthop 144:16–26

    Google Scholar 

  • Lippacher S, Dejour D, Elsharkawi M et al (2012) Observer agreement on the Dejour trochlear dysplasia classification: a comparison of true lateral radiographs and axial magnetic resonance images. Am J Sports Med. doi:10.1177/0363546511433028

    Google Scholar 

  • Maldague B, Malghem J (1985) Significance of the radiograph of the knee profile in the detection of patellar instability. preliminary report. Rev Chir Orthop Réparatrice Appar Mot 71(Suppl 2):5–13

    PubMed  Google Scholar 

  • Malghem J, Maldague B (1989) Patellofemoral joint: 30 degrees axial radiograph with lateral rotation of the leg. Radiology 170:566–567

    CAS  PubMed  Google Scholar 

  • Martinez S, Korobkin M, Fondren FB et al (1983) Computed tomography of the normal patellofemoral joint. Invest Radiol 18:249–253

    Article  CAS  PubMed  Google Scholar 

  • Merchant AC, Mercer RL, Jacobsen RH, Cool CR (1974) Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 56:1391–1396

    CAS  PubMed  Google Scholar 

  • Miller TT, Staron RB, Feldman F (1996) Patellar height on sagittal MR imaging of the knee. AJR Am J Roentgenol 167:339–341

    Article  CAS  PubMed  Google Scholar 

  • Neyret P, Robinson AHN, Le Coultre B et al (2002) Patellar tendon length–the factor in patellar instability? Knee 9:3–6

    Article  PubMed  Google Scholar 

  • Pfirrmann CW, Zanetti M, Romero J, Hodler J (2000) Femoral trochlear dysplasia: MR findings1. Radiology 216:858–864

    Article  CAS  PubMed  Google Scholar 

  • Schoettle PB, Zanetti M, Seifert B et al (2006) The tibial tuberosity-trochlear groove distance; a comparative study between CT and MRI scanning. Knee 13:26–31. doi:10.1016/j.knee.2005.06.003

    Article  PubMed  Google Scholar 

  • Schutzer SF, Ramsby GR, Fulkerson JP (1986) Computed tomographic classification of patellofemoral pain patients. Orthop Clin N Am 17:235–248

    CAS  Google Scholar 

  • Shellock FG, Mink JH, Fox JM (1988) Patellofemoral joint: kinematic MR imaging to assess tracking abnormalities. Radiology 168:551–553

    CAS  PubMed  Google Scholar 

  • Shellock FG, Mink JH, Deutsch AL, Fox JM (1989) Patellar tracking abnormalities: clinical experience with kinematic MR imaging in 130 patients. Radiology 172:799–804

    CAS  PubMed  Google Scholar 

  • Virolainen H, Visuri T, Kuusela T (1993) Acute dislocation of the patella: MR findings. Radiology 189:243–246

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Instituto de Ortopedia e Traumatologia de Passo Fundo, Rua Uruguai 2050, 99010-111, Passo Fundo, RS, Brazil

    Paulo Renato Fernandes Saggin

  2. Department of Knee Surgery & Sports Traumatology, Lyon-Ortho-Clinic; Clinique de la Sauvegarde, 8 Avenue David Ben Gourion, 69009, Lyon, France

    David Dejour

Authors
  1. Paulo Renato Fernandes Saggin
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  2. David Dejour
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Correspondence to Paulo Renato Fernandes Saggin .

Editor information

Editors and Affiliations

  1. Dept. Orthopedics & Traumatology, Hacettepe University Fac. Medicine, Ankara, Turkey

    Mahmut Nedim Doral

  2. Gothenburg, Sweden

    Jon Karlsson

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Fernandes Saggin, P.R., Dejour, D. (2014). Radiologic Criteria in Patellar Dislocations. In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_120-1

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  • DOI: https://doi.org/10.1007/978-3-642-36801-1_120-1

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  • Online ISBN: 978-3-642-36801-1

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