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急性外侧髌骨脱位与多韧带膝关节损伤中内侧髌股韧带损伤特征的差异。

Differences of injury characteristics of medial patellofemoral ligament in acute lateral patellar dislocation and multiligament knee injuries.

机构信息

Department of Radiology, Shandong Provincial Corps Hospital of Chinese People's Armed Police Forces, Jinan, PR China.

Graduate School, Shandong First Medical University, Jinan, PR China.

出版信息

Acta Radiol. 2023 May;64(5):1934-1942. doi: 10.1177/02841851231153287. Epub 2023 Feb 5.

Abstract

BACKGROUND

The injury characteristics of medial patellofemoral ligament (MPFL) in multiligament knee injuries (MLKIs) and the differences of injury patterns of MPFL in MLKIs and acute lateral patellar dislocation (LPD) remain unclear.

PURPOSE

To explore the differences of injury characteristics of MPFL after acute LPD and MLKIs.

METHODS

Magnetic resonance images were prospectively analyzed in 219 patients after acute LPD or MLKIs. Statistical analyses of the injury patterns of MPFL were performed between LPD and MLKIs.

RESULTS

The incidence of partial tear and complete MPFL tear in adolescent LPD and MLKIs were 40.3% and 48.4%, and 27.9% and 16.3%, respectively. Compared with LPD, MLKIs showed lower incidence rates of partial and complete MPFL tears (both = 0). The MLKI subgroup showed lower incidence rates of MPFL tear at the patellar insertion (PAT), femoral attachment (FEM), and multiple-site of the MPFL (COM) (9.3%, 20.9%, and 14%) when compared with the LPD subgroup (45.2%, 24.2%, and 16.1%) (all < 0.01). The incidence of partial tear and complete MPFL tear in adult LPD and MLKIs were 41.5% and 47.2%, and 24.6% and 16.4%, respectively. Compared with LPD, MLKIs showed lower incidence rates of partial and complete MPFL tears (both = 0). The MLKI subgroup showed lower incidence rates of MPFL tear at PAT, FEM, and COM (8.2%, 18%, and 14.8%) when compared with the LPD subgroup (20.8%, 34%, and 30.2%) (all = 0).

CONCLUSION

Compared with LPD, MPFL tears are relatively uncommon in MLKIs. Even if MPFL tears occur, partial tears and femoral-sided tears are relatively more common.

摘要

背景

多韧带膝关节损伤(MLKIs)中内侧髌股韧带(MPFL)的损伤特征以及 MPFL 在 MLKIs 和急性外侧髌脱位(LPD)中的损伤模式差异尚不清楚。

目的

探讨急性 LPD 和 MLKIs 后 MPFL 损伤特征的差异。

方法

前瞻性分析 219 例急性 LPD 或 MLKIs 患者的磁共振成像。对 LPD 和 MLKIs 之间 MPFL 损伤模式进行统计学分析。

结果

青少年 LPD 和 MLKIs 中 MPFL 部分撕裂和完全撕裂的发生率分别为 40.3%和 48.4%,27.9%和 16.3%。与 LPD 相比,MLKIs 中 MPFL 部分和完全撕裂的发生率较低(均 P=0)。MLKI 亚组 MPFL 在髌韧带止点(PAT)、股骨附着处(FEM)和 MPFL 多部位(COM)的撕裂发生率(9.3%、20.9%和 14%)低于 LPD 亚组(45.2%、24.2%和 16.1%)(均 P<0.01)。成人 LPD 和 MLKIs 中 MPFL 部分撕裂和完全撕裂的发生率分别为 41.5%和 47.2%,24.6%和 16.4%。与 LPD 相比,MLKIs 中 MPFL 部分和完全撕裂的发生率较低(均 P=0)。MLKI 亚组 PAT、FEM 和 COM 处的 MPFL 撕裂发生率(8.2%、18%和 14.8%)低于 LPD 亚组(20.8%、34%和 30.2%)(均 P=0)。

结论

与 LPD 相比,MPFL 撕裂在 MLKIs 中相对少见。即使发生 MPFL 撕裂,也更常见部分撕裂和股骨侧撕裂。

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