First time acute lateral patellar dislocation in children and adolescents: what about unaffected knee patellofemoral joint anatomic abnormalities?
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2018-05-10 |
Introduction The fi rst-time acute lateral patellar dislocation (LPD) is a common injury for children. The two most important anatomical variants in LPD-femoral trochlear groove and patella alta. Objective The aim of the present prospective study was to report the patellofemoral joint (PFJ) anatomic abnormalities prevalence and combinations of unaff ected contralateral knees in children traumatic fi rst time LPD. Material and methods The study approved the medical ethics committee. Patients till 18 years, 2012 and 2016 yr. with the fi rst time acute LPD requiring reduction were involved. Exclusion criteria of the patients from the study were selected. 58 patients (boy/girl 23/35; age range 11–18 years) with acute primary LPD were selected prospectively. Patients had clinical, X-ray (AP, Mercer-Merchant views), CT of both knees. 3 gr. were formed as follows: 14 patients (A gr.) with aff ected knee sulcus angle (SA) ≤138°; 21 (B gr.) with SA from 138° to 145°; and 23 (C gr.)- SA >145°. Patellar height and sulcus angle were measured according to the Blackburne – Peel and Brattstroem methods r. Patients age, gender, height, weight, BMI and its percentiles were statistically similar in the all groups. Statistical analysis: the Mann- Whitney U, chi-square tests and the Pearson correlation coeffi cient. Signifi cance p<0.05. Results: 71.4% of patients in gr. A and 95.2% in B and 87% C gr. had a high-riding patella. There was a statistically signifi cant diff erence between patients from the A and B gr. The mean patellar height ratio was 1.15 in A gr. patients, 1.33 in B and 1,33 in C gr. The patellar height ratio correlated with SA (r ꞊ 0.537, p<0.05) for A gr. Conclusions The incidence of patella alta and trochlear dysplasia combination is the same in the aff ected and contralateral intact knees. There was no diff erence in femoral sulcus angles of the contralateral intact knees in patients with [...].