Abstract
BackgroundThe 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.MethodsA 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).ResultsInitial 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.ConclusionsThis 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.
Highlights
A patella dislocation is a multifactorial phenomenon that can have numerous long-term sequelae [1] Following a single dislocation, a large proportion of patients continue to endure symptoms [2] including pain and recurrent instability, which may result in a restriction in their activites [3]
Our knowledge on the diagnosis and management of patella instability has grown in recent years, but our understanding about the mechanism by which the dislocation occurs remains limited and this is an important element of developing an injury prevention model
The aim of this study was to identify the mechanism of injury of patella dislocations using systematic video analysis of publicly available videos on open-access video sharing websites
Summary
A patella dislocation is a multifactorial phenomenon that can have numerous long-term sequelae [1] Following a single dislocation, a large proportion of patients continue to endure symptoms [2] including pain and recurrent instability, which may result in a restriction in their activites [3]. Its use has gained popularity in recent years following work on cervical spine injuries in rugby [6]. This was followed, famously, by the work of Ettlinger [7] in identifying the “phantom foot” mechanism of anterior cruciate ligament (ACL) injury in skiers. They were able to use this understanding to reduce the incidence of ACL injuries by 62% through the development of a video-based training programme. The aim of this study was to use systematic video analysis to determine the MoI of a patella dislocation
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