ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Knee Magnetic Resonance Imaging Of 150 Lateral Patellar Dislocation Patients - More (Pathologic Findings) Than Meets The Eye

Ran Thein, MD, Ramat-Gan ISRAEL
Ophir Segal, MD, Rishon Le-Zion, ISRAEL ISRAEL
Sheba Medical Center, RAMAT GAN, ISRAEL

FDA Status Not Applicable

Summary

Overall, 28.7% of the MRI of patients with established diagnosis of lateral patellar dislocation were positive for additional pathological radiologic findings including MCL, LCL, ACL. PCL or menisci injuries

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Abstract

Purpose

Patients with established diagnosis of lateral patellar dislocation (LPD) might have additional knee pathological findings including MCL, LCL, ACL. PCL or menisci injuries. Unfortunately, these findings might be masked during the physical examination by nonspecific clinical findings including pain and hemarthrosis. Since the patients don’t always refer for an MRI, the prevalence of these findings is misreported in the literature and consider rare. Thus, the current study was designed to evaluate the prevalence of these pathologies in patients with acute traumatic LPD.

Materials And Methods

knee MRI of patients with traumatic LPD were evaluated for the presence of additional pathologies. A comparison between patients was performed according to age(><25 years), sex(Male/Female), and TT-TG distance (><15mm).

Results

150 patients were included. (mean age 21.3(±SD 8.9), 86 males). Overall 43/150 (28.7%) of the MRI were positive for additional pathological radiologic findings.
Older patients had a statistically significant higher PCL, medial meniscus (MM) and lateral meniscus (LM) tears (10.5% vs 1.8%, p=0.0362. 18.4% vs 2.7%, p=0.0027 and 7.9% vs 0%, p= 0.0153 respectively). Male patients had a statistically significant higher prevalence of nondisplaced MM tear and LCL injury compare to females (8.1% vs 0%, p= 0.0204. 8.1% vs 0%, p=0.0204 respectively). Patients with TT-TG distance greater then 15mm had a statistically significant higher ACL injury (17.5% vs 2.3%, p= 0.0184).

Conclusions

This is the first study to report additional pathological findings of knee’s MRI in patients with established diagnosis of LPD.
Interestingly, higher prevalence of additional pathologies were found in the groups of patients with lower risk for recurrent LPD including, males, patients older than 25 and patients with TT-TG distance lower than 15mm. Since surgical intervention is not always indicated in these patients, they may not be referred for an MRI. Thus, we recommend a strict physical examination, awareness to high prevalence of additional pathological findings and to consider refer all patients after every LPD for an MRI.

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