Patella Dislocation: an Online Systematic Video Analysis of the Mechanism of Injury

Overview

Journal Knee Surg Relat Res

Publisher Biomed Central

Date 2020 Jul 15

PMID 32660635

Citations 5

Authors

V Dewan

M S L Webb

D Prakash

A Malik

S Gella

C Kipps

Affiliations

Soon will be listed here.

Abstract

Background: The mechanism of injury (MoI) for a patellar dislocation has not been fully established. The aim of this study was to use systematic video analysis to determine the MoI of a patella dislocation.

Methods: A systematic search was conducted of three video sharing websites and three popular search engines to identify videos demonstrating a patellar dislocation. Videos were reviewed by three surgeons trained in systematic video analysis, who commented on the position of the lower limb and the situation in which the injury occurred. The results were reviewed to build a consensus of the MoI for each video. Statistical analysis was conducted for interobserver agreement (p < 0.05).

Results: Initial search yielded 603 videos with 13 meeting the inclusion criteria. The injuries were sustained performing a sporting activity (n = 9) or whilst dancing (n = 4). The injury was predominantly sustained during a non-contact situation (n = 10). The most common mechanism was an unbalanced individual with a flexed hip sustaining a valgus force to their flexed knee with the tibia externally rotated.

Conclusions: This study provides some insight into the MoI for a patellar dislocation and the findings may assist in developing injury prevention programmes and rehabilitation protocols as well as guiding future research.

Citing Articles

Patterns of Avulsion and Osteochondral Fractures Associated with Patellar Dislocations: A Descriptive Study Using 3-Dimensional Computed Tomography.

Kose O, Dogruoz F, Egerci O, Aykanat F, Kilic K Clin Orthop Surg. 2025; 17(1):100-111.

PMID: 39912067 PMC: 11791499. DOI: 10.4055/cios24270.

Patellar Dislocation: Workup and Decision-Making.

Samelis P, Koulouvaris P, Savvidou O, Mavrogenis A, Samelis V, Papagelopoulos P Cureus. 2023; 15(10):e46743.

PMID: 38021800 PMC: 10631568. DOI: 10.7759/cureus.46743.

Medial patellofemoral ligament reconstruction appears to be a better treatment than repair, proximal realignment, or conservative management for primary patellar dislocation: A network meta-analysis.

Yoo J, Huh M, Lee C, Roh Y, DLima D, Shin Y Medicine (Baltimore). 2023; 102(39):e35251.

PMID: 37773862 PMC: 10545352. DOI: 10.1097/MD.0000000000035251.

Reliability of the TT-TG Index Versus TT-TG Distance on MRI: Morphometric Analyses in Asian Children and Adolescents.

Park S, Choi W, Yoon S, Rhie J, Ahn W, Oh J Orthop J Sports Med. 2023; 11(6):23259671221145228.

PMID: 37378281 PMC: 10291415. DOI: 10.1177/23259671221145228.

Challenging the mechanism of distal biceps tendon rupture using a video analysis study.

Jukes C, Dirckx M, Bellringer S, Chaundy W, Phadnis J Bone Jt Open. 2022; 3(10):826-831.

PMID: 36243942 PMC: 9626872. DOI: 10.1302/2633-1462.310.BJO-2022-0123.R1.

References

Cash J, HUGHSTON J . Treatment of acute patellar dislocation. Am J Sports Med. 1988; 16(3):244-9. DOI: 10.1177/036354658801600308. View

Fithian D, Paxton E, Stone M, Silva P, Davis D, Elias D . Epidemiology and natural history of acute patellar dislocation. Am J Sports Med. 2004; 32(5):1114-21. DOI: 10.1177/0363546503260788. View

Ettlinger C, Johnson R, Shealy J . A method to help reduce the risk of serious knee sprains incurred in alpine skiing. Am J Sports Med. 1995; 23(5):531-7. DOI: 10.1177/036354659502300503. View

Krosshaug T, Nakamae A, Boden B, Engebretsen L, Smith G, Slauterbeck J . Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases. Am J Sports Med. 2006; 35(3):359-67. DOI: 10.1177/0363546506293899. View

Kwon J, Chacko A, Kadzielski J, Appleton P, Rodriguez E . A novel methodology for the study of injury mechanism: ankle fracture analysis using injury videos posted on YouTube.com. J Orthop Trauma. 2010; 24(8):477-82. DOI: 10.1097/BOT.0b013e3181c99264. View

van Mechelen W, Hlobil H, Kemper H . Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med. 1992; 14(2):82-99. DOI: 10.2165/00007256-199214020-00002. View

Schreiber J, Warren R, Hotchkiss R, Daluiski A . An online video investigation into the mechanism of elbow dislocation. J Hand Surg Am. 2013; 38(3):488-94. DOI: 10.1016/j.jhsa.2012.12.017. View

Atkin D, Fithian D, Marangi K, Stone M, Dobson B, Mendelsohn C . Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6 months of injury. Am J Sports Med. 2000; 28(4):472-9. DOI: 10.1177/03635465000280040601. View

HUGHSTON J . Reconstruction of the extensor mechanism for subluxating patella. J Sports Med. 1972; 1(1):6-13. DOI: 10.1177/036354657200100101. View

10.

Silver J, Gill S . Injuries of the spine sustained during rugby. Sports Med. 1988; 5(5):328-34. DOI: 10.2165/00007256-198805050-00005. View

11.

Nikku R, Nietosvaara Y, Aalto K, Kallio P . The mechanism of primary patellar dislocation: trauma history of 126 patients. Acta Orthop. 2009; 80(4):432-4. PMC: 2823187. DOI: 10.3109/17453670903110634. View

12.

Hawkins R, Bell R, Anisette G . Acute patellar dislocations. The natural history. Am J Sports Med. 1986; 14(2):117-20. DOI: 10.1177/036354658601400204. View

13.

Stathopulu E, Baildam E . Anterior knee pain: a long-term follow-up. Rheumatology (Oxford). 2003; 42(2):380-2. DOI: 10.1093/rheumatology/keg093. View

14.

Powers C . The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003; 33(11):639-46. DOI: 10.2519/jospt.2003.33.11.639. View

15.

Mitchell J, Magnussen R, Collins C, Currie D, Best T, Comstock R . Epidemiology of Patellofemoral Instability Injuries Among High School Athletes in the United States. Am J Sports Med. 2015; 43(7):1676-82. DOI: 10.1177/0363546515577786. View

16.

Yamada Y, Toritsuka Y, Horibe S, Sugamoto K, Yoshikawa H, Shino K . In vivo movement analysis of the patella using a three-dimensional computer model. J Bone Joint Surg Br. 2007; 89(6):752-60. DOI: 10.1302/0301-620X.89B6.18515. View

17.

Longo U, Huijsmans P, Maffulli N, Denaro V, de Beer J . Video analysis of the mechanisms of shoulder dislocation in four elite rugby players. J Orthop Sci. 2011; 16(4):389-97. DOI: 10.1007/s00776-011-0087-6. View

18.

Maletius W, Gillquist J, Messner K . Acute patellar dislocation during eccentric muscle testing on the Biodex dynamometer. Arthroscopy. 1994; 10(4):473-4. DOI: 10.1016/s0749-8063(05)80203-8. View

19.

Bahr R, Krosshaug T . Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med. 2005; 39(6):324-9. PMC: 1725226. DOI: 10.1136/bjsm.2005.018341. View