Habitual patellar dislocation exhibits less severe rotational deformities but poorer trochlear development and higher incidence of patella baja compared with recurrent patellar dislocation in skeletally mature patients

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-08-09 DOI:10.1002/ksa.12392

Zhijun Zhang, Zheng Feng, Menglinqian Di, Daofeng Wang, Tong Zheng, Hui Zhang

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Abstract

Purpose

This study compared the radiological characteristics between habitual and recurrent patellar dislocation in skeletally mature patients.

Methods

From 2017 to 2019, 77 skeletally mature patients with habitual patellar dislocation were surgically treated at a single institution and reviewed retrospectively. A total of 55 knees from these patients were included in the habitual patellar dislocation group. During the same period, 55 knees with recurrent patellar dislocation were randomly selected from 242 patients and included in the recurrent patellar dislocation group. Various bony deformities were measured and compared between the two groups. Additionally, a subgroup analysis was conducted among patients with habitual patellar dislocation, comparing those with and without an ‘invisible patella’ observed on true lateral views with 30° of knee flexion.

Results

The femoral anteversion angle (21.8° vs. 26.3°, p = 0.041), tibiofemoral rotation angle (9.7° vs. 12.4°, p = 0.042) and external tibial rotation angle (24.3° vs. 29.6°, p = 0.001) in the habitual patellar dislocation group were significantly lower than those in the recurrent patellar dislocation group. 54% of knees in the habitual patellar dislocation group had a patella baja, and this was in sharp contrast to the recurrent patellar dislocation group in which none of the knees had a patella baja. 49.1% of knees in the habitual patellar dislocation group showed ‘invisible patella’ at 30° of knee flexion, and knees with ‘invisible patella’ had significantly higher tibial tubercle-trochlear groove (TT-TG) distance (30.4 vs. 19.8, p < 0.001) and tibiofemoral rotation angle (13.2° vs. 6.4°, p < 0.001) than knees with a visible patella.

Conclusions

A distinct difference in bony anatomical features was observed between habitual and recurrent patellar dislocation in skeletally mature patients. Habitual patellar dislocation exhibited less severe rotational deformities of the lower extremity but showed poorer trochlear and patellar development, a larger TT-TG distance and a higher incidence of patella baja compared with recurrent patellar dislocation.

Level of Evidence

Level III.

Abstract Image

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与骨骼发育成熟的复发性髌骨脱位患者相比，习惯性髌骨脱位患者的旋转畸形程度较轻，但髌骨发育较差，髌骨脱位的发生率较高。

目的：该研究比较了骨骼发育成熟患者习惯性髌骨脱位和复发性髌骨脱位的放射学特征：从 2017 年到 2019 年，77 名骨骼发育成熟的习惯性髌骨脱位患者在一家机构接受了手术治疗，并进行了回顾性回顾。这些患者中共有55个膝关节被纳入习惯性髌骨脱位组。同一时期，从242名患者中随机抽取了55个复发性髌骨脱位的膝关节，并将其纳入复发性髌骨脱位组。对两组患者的各种骨骼畸形进行了测量和比较。此外，还对习惯性髌骨脱位患者进行了亚组分析，比较了在膝关节屈曲30°的真实侧视图上观察到的有 "隐形髌骨 "和没有 "隐形髌骨 "的患者：结果：习惯性髌骨脱位组的股骨内翻角（21.8° vs. 26.3°，p = 0.041）、胫骨股骨旋转角（9.7° vs. 12.4°，p = 0.042）和胫骨外旋角（24.3° vs. 29.6°，p = 0.001）明显低于复发性髌骨脱位组。习惯性髌骨脱位组中有54%的膝关节有髌骨脱位，这与复发性髌骨脱位组中没有膝关节有髌骨脱位形成鲜明对比。习惯性髌骨脱位组中有49.1%的膝关节在屈膝30°时出现 "隐形髌骨"，出现 "隐形髌骨 "的膝关节的胫骨结节-趾骨沟（TT-TG）距离明显更高（30.4对19.8，P 结论：习惯性髌骨脱位组与复发性髌骨脱位组在骨骼解剖学上存在明显差异：在骨骼发育成熟的患者中，习惯性髌骨脱位和复发性髌骨脱位的骨骼解剖特征存在明显差异。与复发性髌骨脱位相比，习惯性髌骨脱位的下肢旋转畸形程度较轻，但蹄骨和髌骨的发育较差，TT-TG距离较大，髌骨骨性脱位的发生率较高：证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).