Am J Sports Med 32:11141121, Tsavalas N, Katonis P, Karantanas AH (2012) Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study. ADVERTISEMENT: Supporters see fewer/no ads. Patellar maltracking occurs as a result of an imbalance in the dynamic relationship between the patella and trochlea. 2002 Dec;225(3):736-43. doi: 10.1148/radiol.2253011578. Other structures combine to form the region referred to as the medial retinaculum (MR) more anteriorly. A 2015 Cochrane Review concluded that there is no significant increase in functional scores between nonoperative and operative management; however, surgical management does result in a significantly lower risk of recurrent dislocation at the cost of surgical complications [19]. The vastus medialis oblique (VMO) provides active stability of the patella. The radiograph can also be useful in detecting osseous morphologic features associated with patellar maltracking such as patella alta and trochlear dysplasia [24, 25]. This is often secondary to an underlying structural abnormality. Between 15 and 45% of patients will develop recurrent patellar instability after acute dislocation, which is both functionally limiting and painful [17,18,19,20]. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Am J Sports Med 33:220230, Nikku R, Nietosvaara Y, Aalto K, Kallio PE (2005) Operative treatment of primary patellar dislocation does not improve medium-term outcome: a 7-year follow-up report and risk analysis of 127 randomized patients. It takes a very strong force to tear the patellar tendon. Lateral patellar dislocation refers to lateral displacement followed by dislocation of the patella due to disruptive changes to the medial patellar retinaculum. 9). This treatment generally consists of the use of anti-inflammatory medications, a short period of immobilization (36weeks) followed by a progressive physiotherapy regimen with focus on range of motion, closed chain exercises, and vastus medialis obliquus strengthening [16, 65,66,67,68,69,70]. Discussion. The TT-TG is evaluated by measuring the distance between the most anterior point of the tibial tuberosity and the deepest point of the trochlear groove using two lines drawn perpendicular to the tangent to the posterior borders of the femoral condyles [31] (Fig. Understanding the biomechanics of these joints is essential to investigating and appropriately treating patellofemoral joint pathology. Patellar dislocation accounts for ~3% of all knee injuries and is commonly seen in those individuals who participate in sports activities. 2. Flattening or developmental dysplasia of the trochlea leads to loss of normal patellar tracking and can predispose to lateral patellar dislocation with flexion. Bone bruise in acute traumatic patellardislocation: volumetric magnetic resonance imaging analysis with follow-up mean of 12 months. Radiographics 30:961981, Tscholl PM, Wanivenhaus F, Fucentese SF (2017) Conventional radiographs and magnetic resonance imaging for the analysis of trochlear dysplasia: the influence of selected levels on magnetic resonance imaging. Cookies policy. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Kamel S, Kanesa-Thasan R, Dave J et al. The knee is a complex joint with separate tibio-femoral and the patellofemoral articulations. Jibri, Z., Jamieson, P., Rakhra, K.S.
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