Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
Dr. Balog is a Staff Orthopedic Surgeon, Tripler Army Medical Center, Honolulu, Hawaii. Mr. Blanks is a Staff Physician Assistant, OrthoGeorgia, Macon, Georgia. Dr. Dykstra is a Staff Orthopedic Surgeon, Black Hills Orthopedic and Spine Center, Rapid City, South Dakota. Dr. Parada is Staff Orthopedic Surgeon, Eisenhower Army Medical Center, Fort Gordon, Georgia. Dr. Arrington is a Staff Orthopedic Surgeon and Director, Orthopedic Surgery Residency Program, Madigan Army Medical Center, Tacoma, Washington.
Address correspondence to: LTC Todd P. Balog, MD, 1 Jarrett White Rd, Honolulu, HI 96859 (tel, 832-326-5583; email, tbalog99@gmail.com).
MAJ Todd P. Balog, MD MAJ Benjamin P. Blanks, PA MAJ Aaron D. Dykstra, MD MAJ Stephen A. Parada, MD COL (ret) Edward D. Arrington, MD . Epidemiology of Existing Extensor Mechanism Pathology in Primary Anterior Cruciate Ligament Ruptures in an Active-Duty Population. Am J Orthop.
August 31, 2018
References
RESULTS
A total of 197 active-duty patients, including 27 females (13.7%) and 170 males (86.3%), underwent primary ACL reconstruction during the study time period. A total of 93 right knees and 104 left knees were evaluated. The average age at presentation was 29 years (range, 19-45 years).
Of the 197 patients, only 1 was found to have a multipartite patella (prevalence, 0.5%). This 37-year-old male patient showed a right bipartite patella located in the superior-lateral aspect (Figure 1).
Four patients had free ossicles within the inferior patellar tendon consistent with unresolved Osgood-Schlatter’s disease (prevalence, 2.0%) (Figure 2). All 4 patients were male, which is consistent with the higher incidence of Osgood-Schlatter’s disease in males than in females. The average age of these patients was 27.5 years (range, 22-33 years).
The most common extensor mechanism pathology present on preoperative imaging was proximal patella tendon thickening suggestive of patella tendinopathy. Thickening of the proximal portion of the patellar tendon was present in 15 of the 197 MRIs (prevalence, 7.6%) (Figure 3). The average width of this thickening was 8.49 mm (7.17-10.17 mm), and the average age of patients with radiographic evidence of patellar tendinopathy was 29.9 years (range, 20-43 years). Gender distribution was predominantly male (14 males, 1 female). Details of all extensor mechanism pathologies found are provided in the Table.
