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Articular Cartilage Injury with Acute Patellar Dislocation in Adolescents

Arthroscopic and Radiographic Correlation

Carl L. Stanitski, MD and George A. Paletta, Jr, MD

Children’s Hospital of Michigan, Detroit, Michigan

Presented in part at the interim meeting of the AOSSM, Atlanta, Georgia, February 1996, and at the 98th annual meeting of the AOA, Colorado Springs, Colorado, June 1996.

Address correspondence and reprint requests to Carl L. Stanitski, MD, Department of Orthopaedics, Children’s Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201

Acute patellar dislocation and relocation produces major forces at the articular surfaces. Articular injury was assessed in 48 patients, 24 boys and 24 girls (mean age, 14 years), with acute, initial, noncontact patellar dislocations. Correlation of the findings of radiographic and arthroscopic examinations was done. Eleven of the 48 patients (23%) had radiologic diagnoses of articular injuries. Thirty-four of the 48 patients (71%) had arthroscopic evidence of articular damage, 32 osteochondral and 2 chondral injuries. Eight of the 28 (29%) arthroscopically identified osteochondral loose bodies (4 to 20 mm) were identified radiologically. Overall, only 11 of the 34 (32%) arthroscopically documented articular injuries were defined by preoperative radiographs. These standard radiographs provided limited information for management decisions. Poor results after patellar dislocation treatment may involve nonrecognition of articular compromise.

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