Pediatrik Akut Lateral Patellar Çıkığı: Medial Patellofemoral Bağ Yaralanma Paternlerinin ve İlişkili Diz Patolojilerinin MRG ile Değerlendirilmesi

Year 2025, Volume: 6 Issue: 3, 266 - 279, 28.09.2025

Saffet Öztürk , Esin Kurtuluş Öztürk , Berna Ucan , Yılmaz Ergişi

https://doi.org/10.47482/acmr.1621101

Abstract

Arka Plan: Akut lateral patellar dislokasyonda (ALPD) medial patellofemoral ligament (MPFL) yaralanma paterni ile eşlik eden anatomik faktörler, eklem kıkırdağı lezyonları ve diz yumuşak doku yaralanmaları arasındaki ilişkiyi değerlendirmeyi amaçladık.
Yöntemler: ALPD'li 102 çocuğun diz MR'ları retrospektif olarak değerlendirildi. MPFL yaralanmasının yeri ve şiddeti, ilişkili anatomik varyasyonlar, kıkırdak lezyonları, diz bağları ve menisküsler değerlendirildi.
Sonuçlar: 53 hastada kısmi MPFL yırtığı ve 49 hastada tam MPFL yırtığı gözlendi. Yaralanma 77 hastada (%77,5) patella insersiyon yerindeydi. Hastalarımızın %86,3'ünde troklear displazi ve patella alta mevcuttu. Wiberg tip B ve C patella ellişer hastada izlendi. Patellar kıkırdak lezyonu 45 hastada (%44,1) izlendi ve tam MPFL yırtıklarında daha yaygındı (p <0,001). Patellar kıkırdak lezyonu patellar insersiyon (PAT) alt grubunda daha fazla görüldü (p=0,005). MCL yaralanması 55 hastada görüldü ve tam MPFL yırtıklarında daha belirgindi (p=0,002). LCL yaralanması 28 hastada (%27,5) görüldü ve PAT alt grubunda daha yaygındı (p=0,002). Kas yaralanması 12 hastada (%11,8) görüldü.
Sonuç: ALPD'li çocuklarda MPFL yaralanması daha sıklıkla kısmi ve PAT'ta görülür. Kıkırdak lezyonları tam MPFL yırtıklarında daha yaygındır. MRI, MPFL yaralanmasının yerini ve şiddetini belirlemede ve ilişkili kıkırdak ve bağ patolojilerini değerlendirmede çok faydalıdır.

Keywords

Medial patellofemoral ligament , akut lateral patellar dislokasyon , MRG , çocuklar , anatomik faktörler , kıkırdak lezyonu

Pediatric Acute Lateral Patellar Dislocation: MRI Assessment of Medial Patellofemoral Ligament Injury Patterns and Associated Knee Pathologies

Abstract

Background: We aimed to evaluate the relationship between the medial patellofemoral ligament (MPFL) injury pattern and accompanying anatomical factors, articular cartilage lesions, and knee soft tissue injuries in acute lateral patellar dislocation (ALPD).
Methods: Knee MRIs of 102 children with ALPD were evaluated retrospectively. The location and severity of MPFL injury, associated anatomical variations, cartilage lesions, and injuries to the knee ligaments and menisci were assessed.
Results: Partial MPFL tears were observed in 53 patients, while complete MPFL tears were observed in 49 patients. The injury site was at the patella insertion in 77 patients (77.5%). Trochlear dysplasia and patella alta were present in 86.3% of the patients. Wiberg type B and C patellae were observed in 50 patients each. Patellar cartilage lesions were seen in 45 patients (44.1%) and were more common in complete MPFL tears (p < 0.001). Patellar cartilage lesions were more prevalent in the patellar insertion (PAT) subgroup (p = 0.005). Medial collateral ligament (MCL) injury was observed in 55 patients and was more prominent in complete MPFL tears (p = 0.002). Lateral collateral ligament (LCL) injury was observed in 28 patients (27.5%) and was more common in the PAT subgroup (p = 0.002). Muscle injury was observed in 12 patients (11.8%).
Conclusion: In children with ALPD, MPFL injury is more commonly partial and occurs at the patellar insertion site. Cartilage lesions are more frequently observed in cases of complete MPFL tears. MRI is a valuable tool in determining the location and severity of MPFL injury and in evaluating associated cartilage and ligament pathologies.

Keywords

Medial patellofemoral ligament , acute lateral patellar dislocation , MRI , children , anatomic factors , cartilage lesion

Ethical Statement

Ethical approval for this study was obtained from the local ethics committee (AEŞH-BADEK-2024-330).

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