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

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 P = 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 P < 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 P = 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 P = 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.

Keywords: Patellar dislocation; magnetic resonance imaging; medial patellofemoral ligament; multiligament knee injury.

MeSH terms

  • Adolescent
  • Adult
  • Humans
  • Knee Injuries* / diagnostic imaging
  • Knee Injuries* / epidemiology
  • Knee Joint
  • Ligaments, Articular / diagnostic imaging
  • Ligaments, Articular / injuries
  • Patellar Dislocation* / diagnostic imaging
  • Patellar Dislocation* / epidemiology
  • Patellar Dislocation* / etiology
  • Rupture