Overview of patellar dislocations in athletes

Abstract

Patellar dislocation is a rare but disabling type of injury commonly effecting adolescents. Up to 55% of patients fail to return to their previous sports activities. Many etiological factors effecting extensor mechanism alignment, trochlear dysplasia, and ligamentous laxity are responsible for this instability. Mainly hip internal rotation accompanied by tibial external rotation together with knee valgus is the most common injury mechanism. Patients mostly attend to emergency with a spontaneously reduced patella. Diagnosis is based on suspicion for spontaneously reduced cases, but frankly, can be done by direct radiographs for dislocated ones. MRI scans might be used to detect soft tissue injuries. Injury to medial structures mainly medial patellofemoral ligament (MPFL) is very common. Different conservative and surgical modalities were described. Modern treatment mainly depends on the patient’s age and type of soft tissue and chondral injury. Definitive treatment of patellar dislocation is not standardized but should be individualized according to the responsible etiologic factors.