Prediction of Subsequent Contralateral Patellar Dislocation after First-Time Dislocation Based on Patellofemoral Morphologies

作者全名："Chen, Jiaxing; Li, Qiaochu; Liu, Sizhu; Fan, Lin; Yin, Baoshan; Yang, Xinyu; Wang, Linbang; Xu, Zijie; Zhang, Jian; Quan, Zhengxue; Zhou, Aiguo"

作者地址："[Chen, Jiaxing; Li, Qiaochu; Fan, Lin; Yin, Baoshan; Yang, Xinyu; Zhang, Jian; Quan, Zhengxue; Zhou, Aiguo] Chongqing Med Univ, Dept Orthoped, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Chen, Jiaxing; Li, Qiaochu; Fan, Lin; Yin, Baoshan; Yang, Xinyu; Zhang, Jian; Quan, Zhengxue; Zhou, Aiguo] Chongqing Med Univ, Orthoped Lab, Chongqing 400016, Peoples R China; [Liu, Sizhu] Chongqing Med Univ, Dept Radiol, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Wang, Linbang] Peking Univ, Dept Orthoped, Hosp 3, Beijing 100191, Peoples R China; [Xu, Zijie] Peking Univ, Sports Med Dept, Beijing Key Lab Sports Injuries, Hosp 3, Beijing 100191, Peoples R China"

通信作者："Quan, ZX; Zhou, AG (通讯作者)，Chongqing Med Univ, Dept Orthoped, Affiliated Hosp 1, Chongqing 400016, Peoples R China.; Quan, ZX; Zhou, AG (通讯作者)，Chongqing Med Univ, Orthoped Lab, Chongqing 400016, Peoples R China."

来源：JOURNAL OF CLINICAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000908539700001

JCR分区：Q1

影响因子：3

年份：2023

卷号：12

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：patellar dislocation; contralateral patellofemoral joint; anatomic risk factor; TT-RA distance; HKA angle

摘要："The subsequent dislocation of a contralateral patellofemoral joint sometimes occurs after a first-time lateral patellar dislocation (LPD). However, the anatomic risk factors for subsequent contralateral LPD remain elusive. This study included 17 patients with contralateral LPD and 34 unilateral patellar dislocators. The anatomic parameters of the contralateral patellofemoral joints were measured using CT images and radiographs that were obtained at the time of the first dislocation. The Wilcoxon rank-sum test was performed, and a binary regression model was established to identify the risk factors. The receiver operating characteristic curves and the area under the curve (AUC) were analyzed. The tibial tubercle-Roman arch (TT-RA) distance was significantly different between patients with and without contralateral LPD (24.1 vs. 19.5 mm, p < 0.001). The hip-knee-ankle (HKA) angle, patellar tilt, congruence angle, and patellar displacement were greater in the study group than in the control group (p < 0.05). The TT-RA distance revealed an OR of 1.35 (95% CI (1.26-1.44]), p < 0.001) and an AUC of 0.727 for predicting contralateral LPD. The HKA angle revealed an OR of 1.74 (95% CI (1.51-2.00), p < 0.001) and an AUC of 0.797. The Patellar tilt, congruence angle, and patellar displacement had AUC values of 0.703, 0.725, and 0.817 for predicting contralateral LPD, respectively. In conclusion, the contralateral patellofemoral anatomic parameters were significantly different between patients with and without subsequent contralateral LPD. Increased TT-RA distance and excessive valgus deformity were risk factors and could serve as predictors for contralateral LPD. At first-time dislocation, the abnormal position of the patella relative to the trochlea may also be an important cause of subsequent LPD."

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