Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital of Shandong University, 16766 Jingshi Rd, Li-Xia District, Jinan, 250014, China.
Department of Radiology, Shandong Provincial Corps Hospital of Chinese People's Armed Police Force, Jinan, 250014, China.
Knee Surg Sports Traumatol Arthrosc. 2018 Mar;26(3):719-726. doi: 10.1007/s00167-016-4408-3. Epub 2016 Dec 27.
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.
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.
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).
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.
IV.
评估成年人初次急性外侧髌骨脱位（LPD）后内侧髌股韧带（MPFL）和股内侧斜肌（VMO）损伤模式之间的相关性。
对 132 例连续急性初次 LPD 成人患者前瞻性行磁共振成像（MRI）检查。使用标准化方案采集和评估图像。根据位置和严重程度对 MPFL 损伤模式进行分组，以分析 VMO 损伤的发生率。
MRI 显示 63 例（47.7%）患者存在 VMO 损伤。20 例（38.5%）和 43 例（56.6%）患者分别存在部分和完全 MPFL 撕裂亚组。与部分 MPFL 撕裂相比，完全撕裂的 VMO 损伤发生率更高（P=0.044）。完全 MPFL 撕裂亚组的冠状位 VMO 平均抬高（28.5mm）和矢状位 VMO 平均抬高（20.7mm）高于部分撕裂亚组（19.8mm，P=0.005；11.9mm，P<0.001）。MPFL 损伤位置亚组与 VMO 损伤发生率之间无相关性（n.s.）。孤立股骨侧（FEM）和合并 MPFL 撕裂（COM）亚组的 VMO 平均抬高更高（FEM 亚组冠状位 VMO 平均抬高 29mm，矢状位 VMO 平均抬高 20.8mm；COM 亚组冠状位 VMO 平均抬高 29.6mm，矢状位 VMO 平均抬高 23.1mm），高于孤立髌骨侧 MPFL 撕裂（PAT）亚组（P=0.022，P<0.001）（PAT 亚组冠状位 VMO 平均抬高 20.7mm，矢状位 VMO 平均抬高 10.6mm）。
成年人初次急性外侧髌骨脱位后，完全性 MPFL 撕裂更易导致 VMO 损伤，且撕裂 VMO 抬高程度更高。孤立股骨侧和合并 MPFL 撕裂更易导致撕裂 VMO 抬高程度更高。
IV。
