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Knee Surgery, Sports Traumatology, Arthroscopy

Leading article of April 2018 >
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14.03.2018

Leading article of March 2018


Anatomic patellar instability risk factors in primary lateral patellar dislocations do not predict injury patterns: an MRI-based study

by

Marc A. Tompkins, Sara R. Rohr, Julie Agel, and Elizabeth A. Arendt

 

The lead article, “Anatomic patellar instability risk factors in primary lateral patellar dislocations do not predict injury patterns: an MRI-based study”, is a review of a large cohort of patients experiencing a primary lateral patella dislocation.  An analysis of a large number of injury factors revealed that many commonly held clinical assumptions were not validated by this study (eg.) chondral damage and the injury pattern of the MPFL have no relationship to the degree of anatomic dysplastic factors.

This paper also led to an understanding of the frequency of injury to the MPTL in lateral patellar dislocations. This prompted a more thorough review of the role of the MPTL including its anatomy, biomechanics, and current clinical use in patella stabilizing procedures (“Medial patellotibial ligament and medial patellomeniscal ligament: anatomy, imaging, biomechanics, and clinical review”).

The article, “Q-vector measurements: physical examination versus magnetic resonance imaging measurements and their relationship with tibial tubercle–trochlear groove distance”), is an attempt to merge the more objective imaging parameters of TT-TG with our common physical exam measurements. One particular physical exam measurement, the tubercle- sulcus angle (TSA), is easy to perform in the operating room. Depending on imaging alone for the degree of correction has a high-risk of over medialization of the tibial tubercle, which can lead to overload in both the medial patellofemoral joint as well as medial tibial-femoral compartments.

It is hoped that the patellofemoral clinician will find these papers interesting and useful.

Elizabeth A. Arendt