Correlation analysis between injury patterns of medial patellofemoral ligament and vastus medialis obliquus after acute first-time lateral patellar dislocation.

Abstract

To evaluate the correlation between injury patterns of the medial patellofemoral ligament (MPFL) and vastus medialis obliquus (VMO) after acute first-time lateral patellar dislocation (LPD) in adults. Magnetic resonance imaging (MRI) was prospectively performed in 132 consecutive adults with acute first-time LPD. Images were acquired and evaluated using standardized protocols. Injury patterns of MPFL were grouped by location and severity for analysis of the prevalence of VMO injury. MRI demonstrated VMO injury in 63 (47.7%) patients. Twenty (38.5%) and 43 cases (56.6%) were present in partial and complete MPFL tear subgroups, respectively. Compared with partial MPFL tears, complete tears showed a higher prevalence of VMO injury (P=0.044). The mean coronal (28.5mm) and mean sagittal VMO elevations (20.7mm) were higher in the complete MPFL tear subgroup than in the partial tear subgroup (19.8mm, P=0.005; 11.9mm, P<0.001). No correlations were identified between the prevalence of VMO injury and location subgroups of MPFL injury (n.s.). Mean VMO elevations were higher in isolated femoral-side (FEM) and combined MPFL tear (COM) subgroups (mean coronal VMO elevation of 29mm and mean sagittal VMO elevation of 20.8mm in the FEM subgroup; mean coronal VMO elevation of 29.6mm and mean sagittal VMO elevation of 23.1mm in the COM subgroup) than in the isolated patellar-side MPFL tear (PAT) subgroup (P=0.022, P<0.001) (mean coronal VMO elevation of 20.7mm and mean sagittal VMO elevation of 10.6mm). Complete MPFL tear predisposes to VMO injury and has a higher elevation of torn VMO after acute first-time LPD in adults. Isolated femoral-side and combined MPFL tears predispose to higher elevation of torn VMO. IV.