The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis

Abstract Purpose The purpose of this study was to examine the thickness of the lateral patellar retinaculum (LPR) and patellar tilt in paediatric and adolescent patients who undergo a medial patellofemoral ligament (MPFL) reconstruction. The authors hypothesise that patients undergoing MPFL reconstr...

Full description

Saved in:
Bibliographic Details
Main Authors: Danielle E. Chipman, Emilie Lijesen, Peter M. Cirrincione, Danielle S. Gorelick, Shae K. Simpson, Douglas N. Mintz, Daniel W. Green
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1002/jeo2.70202
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849234192897933312
author Danielle E. Chipman
Emilie Lijesen
Peter M. Cirrincione
Danielle S. Gorelick
Shae K. Simpson
Douglas N. Mintz
Daniel W. Green
author_facet Danielle E. Chipman
Emilie Lijesen
Peter M. Cirrincione
Danielle S. Gorelick
Shae K. Simpson
Douglas N. Mintz
Daniel W. Green
author_sort Danielle E. Chipman
collection DOAJ
description Abstract Purpose The purpose of this study was to examine the thickness of the lateral patellar retinaculum (LPR) and patellar tilt in paediatric and adolescent patients who undergo a medial patellofemoral ligament (MPFL) reconstruction. The authors hypothesise that patients undergoing MPFL reconstruction will have a thicker LPR and increased patellar tilt when compared to a comparison cohort. Methods Preoperative magnetic resonance imaging (MRI) of patients ≤ 18 years old who underwent an MPFL reconstruction was retrospectively reviewed. Patients were included if they had a proton density preoperative axial MRI performed internally at our institution. Included patients were matched to a comparison cohort. LPR thickness and patellar tilt were measured on MRI. LPR thickness and patellar tilt were compared between the MPFL cohort and the comparison cohort. Results A total of 363 patients were identified. 145 participants were successfully matched to the comparison cohort. The mean age in the MPFL cohort was 14.4 ± 2.0 years and 68% were female. The LPR thickness in the MPFL cohort was significantly greater than the LPR thickness in the comparison cohort (p < 0.001). The patellar tilt was significantly greater in the MPFL cohort compared to the control cohort (p < 0.001). There was no statistical difference in patients undergoing MPFL reconstruction and the occurrence of a lateral release/lengthening procedure. Conclusion The LPR was significantly thicker on preoperative MRI in patients undergoing MPFL reconstruction compared to a comparison cohort, indicating that increased LPR thickness is a potential marker of patellofemoral instability on imaging. Level of Evidence Level III.
format Article
id doaj-art-d68c8f46415a4547a89046c69741ed4c
institution Kabale University
issn 2197-1153
language English
publishDate 2025-04-01
publisher Wiley
record_format Article
series Journal of Experimental Orthopaedics
spelling doaj-art-d68c8f46415a4547a89046c69741ed4c2025-08-20T04:03:13ZengWileyJournal of Experimental Orthopaedics2197-11532025-04-01122n/an/a10.1002/jeo2.70202The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysisDanielle E. Chipman0Emilie Lijesen1Peter M. Cirrincione2Danielle S. Gorelick3Shae K. Simpson4Douglas N. Mintz5Daniel W. Green6Department of Paediatric Orthopedics Hospital for Special Surgery New York New York USADepartment of Paediatric Orthopedics Hospital for Special Surgery New York New York USADepartment of Paediatric Orthopedics Hospital for Special Surgery New York New York USADepartment of Paediatric Orthopedics Hospital for Special Surgery New York New York USADepartment of Paediatric Orthopedics Hospital for Special Surgery New York New York USADepartment of Radiology Hospital for Special Surgery New York New York USADepartment of Paediatric Orthopedics Hospital for Special Surgery New York New York USAAbstract Purpose The purpose of this study was to examine the thickness of the lateral patellar retinaculum (LPR) and patellar tilt in paediatric and adolescent patients who undergo a medial patellofemoral ligament (MPFL) reconstruction. The authors hypothesise that patients undergoing MPFL reconstruction will have a thicker LPR and increased patellar tilt when compared to a comparison cohort. Methods Preoperative magnetic resonance imaging (MRI) of patients ≤ 18 years old who underwent an MPFL reconstruction was retrospectively reviewed. Patients were included if they had a proton density preoperative axial MRI performed internally at our institution. Included patients were matched to a comparison cohort. LPR thickness and patellar tilt were measured on MRI. LPR thickness and patellar tilt were compared between the MPFL cohort and the comparison cohort. Results A total of 363 patients were identified. 145 participants were successfully matched to the comparison cohort. The mean age in the MPFL cohort was 14.4 ± 2.0 years and 68% were female. The LPR thickness in the MPFL cohort was significantly greater than the LPR thickness in the comparison cohort (p < 0.001). The patellar tilt was significantly greater in the MPFL cohort compared to the control cohort (p < 0.001). There was no statistical difference in patients undergoing MPFL reconstruction and the occurrence of a lateral release/lengthening procedure. Conclusion The LPR was significantly thicker on preoperative MRI in patients undergoing MPFL reconstruction compared to a comparison cohort, indicating that increased LPR thickness is a potential marker of patellofemoral instability on imaging. Level of Evidence Level III.https://doi.org/10.1002/jeo2.70202lateral patellar retinaculummedial patellofemoral ligament reconstructionpatellar instabilitypatellar tiltpaediatrics
spellingShingle Danielle E. Chipman
Emilie Lijesen
Peter M. Cirrincione
Danielle S. Gorelick
Shae K. Simpson
Douglas N. Mintz
Daniel W. Green
The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis
Journal of Experimental Orthopaedics
lateral patellar retinaculum
medial patellofemoral ligament reconstruction
patellar instability
patellar tilt
paediatrics
title The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis
title_full The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis
title_fullStr The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis
title_full_unstemmed The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis
title_short The lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability: An MRI analysis
title_sort lateral patellar retinaculum is thicker in paediatric and adolescent patients with patellofemoral instability an mri analysis
topic lateral patellar retinaculum
medial patellofemoral ligament reconstruction
patellar instability
patellar tilt
paediatrics
url https://doi.org/10.1002/jeo2.70202
work_keys_str_mv AT danielleechipman thelateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT emilielijesen thelateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT petermcirrincione thelateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT daniellesgorelick thelateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT shaeksimpson thelateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT douglasnmintz thelateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT danielwgreen thelateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT danielleechipman lateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT emilielijesen lateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT petermcirrincione lateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT daniellesgorelick lateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT shaeksimpson lateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT douglasnmintz lateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis
AT danielwgreen lateralpatellarretinaculumisthickerinpaediatricandadolescentpatientswithpatellofemoralinstabilityanmrianalysis