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Review Question - QID 691

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QID 691 (Type "691" in App Search)
An athlete sustains a traumatic patellar dislocation. The MRI shows a hemarthrosis with a floating osteochondral fragment. Which of the following is the most likely site of origin for the loose fragment?

The lateral patellar facet

12%

308/2600

The medial patellar facet

83%

2169/2600

The odd patellar facet

1%

28/2600

The medial trochlea

2%

61/2600

The central trochlea

1%

20/2600

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Lateral patellar dislocations are by far the most common. The medial facet of the patella will impact on the lateral trochlear ridge. Either of these would be acceptable answers, but lateral trochlea is not listed. Even without an osteochondral fracture, an MRI of an acute patellar dislocation will generally show bone bruises in these two locations.

Nomura looked at 39 consecutive arthroscopies after lateral dislocation and 95% had patellar chondral defects. They also reported that the medial facet of the patella is the most commonly injured site of the patella.

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