Steensen Robert N, Bentley Jared C, Trinh Thai Q, Backes Jeffrey R, Wiltfong Roger E
Department of Orthopaedics, Mount Carmel Health System, Columbus, Ohio, USA
Department of Orthopaedics, Mount Carmel Health System, Columbus, Ohio, USA.
Am J Sports Med. 2015 Apr;43(4):921-7. doi: 10.1177/0363546514563904. Epub 2015 Jan 13.
Anatomic factors, including patella alta, increased tibial tubercle-trochlear groove (TT-TG) distance, rotational deformities, and trochlear dysplasia, are associated with dislocation of the patella. Identifying the presence of these anatomic factors both in isolation and in combination may influence treatment in patients with patellar dislocation.
The aim of this study was to compare the prevalence and combined prevalences of these anatomic factors using magnetic resonance imaging in a group of patients with and without histories of recurrent dislocation of the patella.
Case-control study; Level of evidence, 3.
The prevalence and combined prevalences of patella alta, increased TT-TG distance, rotational deformity, and trochlear dysplasia on magnetic resonance imaging were reported and compared in 60 patients (60 knees) with and 120 patients (120 knees) without histories of recurrent patellar dislocation.
Patients with recurrent patellar dislocation possessed higher rates of patella alta (60.0% vs. 20.8%), increased TT-TG distance (42.0% vs. 3.2%), rotational deformity (26.7% vs. 2.5%), and trochlear dysplasia (68.3% vs. 5.8%) compared with patients without histories of patellar dislocation. Multiple anatomic factors were identified in 58.3% of patients (35/60) with recurrent dislocation compared with only 1.7% of controls (2/120).
Recurrent patellar dislocation is associated with an increased prevalence of patella alta, increased TT-TG distance, rotational deformity, and trochlear dysplasia compared with patients with no histories of patellar dislocation. Multiple anatomic factors were identified in the majority of patients with recurrent dislocation. Further research may identify which factors play a greater role in patellar stability and may allow physicians to predict which first-time dislocation patients are more likely to sustain recurrence.
解剖学因素，包括高位髌骨、胫骨结节 - 滑车沟（TT - TG）距离增加、旋转畸形和滑车发育不良，与髌骨脱位有关。识别这些解剖学因素单独及合并存在的情况可能会影响髌骨脱位患者的治疗。
本研究的目的是使用磁共振成像比较一组有和没有复发性髌骨脱位病史的患者中这些解剖学因素的患病率及合并患病率。
病例对照研究；证据等级，3级。
报告并比较了60例有复发性髌骨脱位病史的患者（60膝）和120例无复发性髌骨脱位病史的患者（120膝）在磁共振成像上高位髌骨、TT - TG距离增加、旋转畸形和滑车发育不良的患病率及合并患病率。
与无髌骨脱位病史的患者相比，复发性髌骨脱位患者的高位髌骨发生率更高（60.0%对20.8%）、TT - TG距离增加发生率更高（4 .0%对3.2%）、旋转畸形发生率更高（26.7%对2.5%）、滑车发育不良发生率更高（68.3%对5.8%）。在58.3%（35/60）有复发性脱位的患者中发现了多种解剖学因素，而对照组中仅为1.7%（2/120）。
与无髌骨脱位病史的患者相比，复发性髌骨脱位与高位髌骨、TT - TG距离增加、旋转畸形和滑车发育不良的患病率增加有关。大多数复发性脱位患者中发现了多种解剖学因素。进一步的研究可能会确定哪些因素在髌骨稳定性中起更大作用，并可能使医生能够预测哪些首次脱位患者更有可能复发。
