Materiały źródłowe

• #1 Patella Dislocation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538288/

  Patellar dislocation accounts for approximately 2 to 3% of knee injuries. This injury tends to affect young and active individuals, with adolescent females and athletes at a higher risk. Incidence is reported as 5.8 per 100,000 but could be as high as 29 per 100,000 in the adolescent population. […] Acute dislocations tend to occur relatively equally in males and females. Patella dislocations are most common in the second and third decades of life.

• #2

  https://www.orthobullets.com/knee-and-sports/3020/patellar-instability

  Patellar instability defines a spectrum from subluxation to dislocation that results from injury, ligamentous laxity, or increased Q angle of the knee. […] Epidemiology […] Incidence […] 2-3% of all knee injuries […] annual risk of first-time patellar dislocation is 5.8 per 100,000. […] Demographic […] most commonly occurs in the 2nd-3rd decades of life. […] Risk factors […] general factors […] ligamentous laxity (Ehlers-Danlos syndrome) […] previous patellar instability event […] recurrence rate of 15-60% following first-time dislocation […] risk of recurrence is 3.8 per 100,000. […] younger age, patella alta, and trochlear dysplasia increase the risk of recurrence.

• #3 Patellar Injury and Dislocation: Background, Epidemiology, Functional Anatomy

  https://emedicine.medscape.com/article/90068-overview

  Pain of the patellofemoral joint secondary to patellofemoral dysfunction is the most common disorder of the knee. A 5-year study published in 1984 revealed that 25% of all knee issues in a sports injury clinic were of patellofemoral origin. Another study similarly revealed that 1 in 4 runners is afflicted by patellofemoral pain. Whether related to sports or not, 1 of every 4 painful knees has been reported to be the result of patellofemoral dysfunction. […] Patellar injury and dislocation are more prevalent in young female athletes. Anterior knee pain is the most common initial manifestation. One study reported 52% of 31 soccer players, 31% of 29 weightlifters, 21% of 28 long-distance runners, and 17% of 29 shooters reported knee pain at least once per month. […] In the general population, patellofemoral instability has been reported to occur in 5.8 per 100,000 persons, whereas in young female athletes (aged 10-17 years) this number has been reported at 29 per 100,000. […] Patellofemoral disorders are more likely the result of inappropriate activity duration and type as opposed to genetic factors.

• #4 Patellar Dislocation – Emergency Department

  https://www.rch.org.au/clinicalguide/guideline_index/fractures/Patellar_Dislocation_-_Emergency_Department/

  Dislocation of the patella is a relatively common injury in the active adolescent population and usually a traumatic event associated with either an awkward fall or direct trauma to the patella itself. […] Most acute patellar dislocations occur in athletically active children with an incidence in the 10- to 17-year age group (29 per 100 000) without a clear gender predilection. […] It is the second most common cause of a knee haemarthrosis second only to ACL injury. […] The risk of dislocation is increased six fold if there is a history of a contralateral dislocation therefore those patients should be referred to Orthopaedic Clinic. […] Acute patellar dislocation is a significant knee injury that in the otherwise normal knee results in recurrent instability in over a third of patients. […] Recovery periods are prolonged and nearly half of the affected patients never return to sport as the knee continues to feel unstable.

• #5 Primary traumatic patellar dislocation | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/1749-799X-7-21

  Acute traumatic patellar dislocation is a common injury in the active and young adult populations. […] The incidence rates of primary patellar dislocation in a population-based setting among adults were revealed in some reports. […] The average annual incidence for patellar dislocation injuries ranged between 5.8 and 7.0 per 100,000 person-years in the civilian population, and up to 29 per 100,000 person-years in the 1017year age group. […] However, the incidence was increased to 69 per 100,000 person-years in the military population who needed to pass physical fitness tests and training requirements of military service. […] Women were more likely to sustain a patellar dislocation injury than men. […] The trend of the highest rates for patellar dislocation injuries in the youngest age group, and rates declined with increasing age were observed not only in military but also in the civilian population-based studies. […] Those previous findings may be associated with increased activity levels in younger individuals and predisposed to anatomic features rendering some youth more vulnerable.

• #6 True Knee + Patellar Dislocations – Core EM

  https://coreem.net/core/true-knee-patellar-dislocations/

  True knee dislocations are rare. […] The Mayo Clinic recorded 14 knee dislocations during an interval of 2 million admissions (Taylor 1972). […] The largest reported series of knee dislocations is from Los Angeles County Hospital, where 53 knee dislocations were reported over a 10-year period. […] The true incidence of knee dislocations is likely higher than reported because 50% of knee dislocations spontaneously reduce before patients present to the emergency department (Kennedy, 1963). […] Annual patellar dislocation rate is approximately 43/100,000 (Brown, 2006). […] The majority are lateral. […] Young athletes suffer patellar dislocations more commonly than any other group, and the average age of occurrence is 16-20 years.

• #7 Patellar dislocation – Wikipedia

  https://en.wikipedia.org/wiki/Patellar_dislocation

  Rate in the United States are estimated 2.3 per 100,000 per year. Rates for ages 10-17 were found to be about 29 per 100,000 persons per year, while the adult population average for this type of injury ranged between 5.8 and 7.0 per 100,000 persons per year. The highest rates of patellar dislocation were found in the youngest age groups, while the rates declined with increasing ages. Females are more susceptible to patellar dislocation. Race is a significant factor for this injury, where Hispanics, African-Americans and Caucasians had slightly higher rates of patellar dislocation due to the types of athletic activity involved in: basketball (18.2%), soccer (6.9%), and football (6.9%), according to Brian Waterman. […] Lateral Patellar dislocation is common among the child population. Some studies suggest that the annual patellar dislocation rate in children is 43/100,000. The treatment of the skeletally immature is controversial due to the fact that they are so young and are still growing. Surgery is recommended by some experts in order to repair the medial structures early, while others recommend treating it non operatively with physical therapy. If re-dislocation occurs then reconstruction of the medial patellofemoral ligament (MPFL) is the recommended surgical option.

• #8 Patellar Dislocation – WikiSM (Sports Medicine Wiki)

  https://wikism.org/Patellar_Dislocation

  Represents about 2-3% of knee injuries […] Overall incidence is around 8 to 43 per 100,000 […] Highest among adolescents aged 14 to 18 years […] Males and females seem to be affected equally […] Recurrence rate following first time dislocation is 15-60%.

• #9 Patellar dislocation – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/patellar-dislocation/

  The first episode of patellar dislocation typically happens before the age of 20 years. […] Up to 45% of patients will have recurrent patellar dislocations after the first episode. […] Epidemiological data refers to the US, unless otherwise specified. […] Over 90% of patellar dislocations result from a twisting injury when the knee is simultaneously in flexion and under valgus strain, often during an activity such as sports or dance, rather than from direct traumatic contact. […] Epidemiology: very rare.

• #10 Patella Dislocation – How Long is Recovery Time? | Jeremy Burnham, MD

  https://www.jeremyburnhammd.com/patella-dislocation-dislocated-kneecap/

  A dislocated kneecap is a relatively common injury, particularly among young athletes. […] Patella dislocation is a relatively common injury, particularly in young people. It is more common in women than men and often occurs during sports that involve sudden stops or changes in direction, such as basketball, football, volleyball, and skiing. […] There are several risk factors that increase the likelihood of patellar dislocation, including: previous patellar dislocation structural abnormalities in the knee, such as a shallow groove for the patella to sit in (trochlear dysplasia) loose ligaments around the knee joint muscle weakness or imbalances around the knee joint impact to the kneecap from the side.

• #11 Patella dislocation – WikEM

  https://wikem.org/wiki/Patella_dislocation

  Acute traumatic dislocations more common in males[2] […] Chronic dislocation seen more commonly in women/teenage girls, typically little or no swelling[2] […] Chronic dislocation more common in females.

• #12 Patella dislocation – WikEM

  http://medbox.iiab.me/modules/en-wikem/wiki/Patella_dislocation.html

  Typically occurs with trauma to an extended knee with externally rotated foot. […] Acute dislocation occurs with traumatic injury, M=F, may see hemarthrosis. […] Chronic dislocation seen more commonly in women/teenage girls, typically little or no swelling. […] Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, White LM. Epidemiology and natural history of acute patellar dislocation. AJSM 2004;32:1114-1121.

• #13 Mental and physical health-related quality of life in patients with recurrent patellar dislocations—a generic and disease-specific quality of life questionnaire assessment | Journal of Experimental Orthopaedics | Full Text

  https://jeo-esska.springeropen.com/articles/10.1186/s40634-022-00499-3

  Lateral dislocation of the patella (LPD) is one of the most common knee joint injuries in adolescents and young adults. The overall risk for experiencing a second LPD after primary dislocation is 29% to 37% and increases to 54% after 15 years. Studies have consistently reported that the younger the patient and the more risk factors are present, the higher the risk of experiencing a second dislocation. […] Without appropriate treatment, LPD can persist for years and relevantly impacts patients disease-specific quality of life (QoL). However, HRQoL includes not only the area of physical well-being but also mental well-being. As a long-lasting disease, LPD might negatively affect all dimensions of HRQoL, but only limited information is available on the influence of LPD on the mental QoL dimension.

• #14 Patellar Dislocation | Orthopedics & Sports Medicine

  https://health.uconn.edu/orthopedics-sports-medicine/conditions-and-treatments/where-does-it-hurt/knee/patellar-dislocation/

  Patellar (kneecap) dislocations occur with significant regularity, especially in younger athletes, with most of the dislocations occurring laterally (outside). […] It has been found in retrospective studies that the incidence of recurrent dislocation after the first dislocation occurs can be as high as 40 percent. Surgically treating those dislocations by lessening lateral tension and tightening medial restraint could reduce this recurrence rate to below 10 percent.

• #15 Lateral patellar dislocation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/lateral-patellar-dislocation?lang=us

  Patellar dislocation accounts for ~3% of all knee injuries and is commonly seen in those individuals who participate in sports activities. […] Risk factors for recurrent patellar dislocations include trochlear dysplasia, patella alta, increased patellar tilt, increased femoral internal rotation, increased TT-TG distance, and changes of Osgood-Schlatter disease.

• #16 Patella dislocation: an online systematic video analysis of the mechanism of injury | Knee Surgery & Related Research | Full Text

  https://kneesurgrelatres.biomedcentral.com/articles/10.1186/s43019-020-00031-w

  The mechanism of injury (MoI) for a patellar dislocation has not been fully established. […] The injury was predominantly sustained during a non-contact situation (n=10). […] 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. […] A patella dislocation is predominantly a non-contact injury. The most common mechanism of a patella dislocation in our series was that of an unbalanced individual with a flexed hip, sustaining a valgus force to their flexed knee with the tibia externally rotated. […] The majority of videos in this study were of individuals who were participating in a sporting activity of some sort, which is in keeping with the findings of other studies. […] However, they also showed that overall, contact patella dislocations were more common amongst male athletes, whilst female athletes sustained more non-contact patella dislocations.

• #17 Knee Dislocation – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470595/

  Knee dislocations are infrequently encountered but are potentially limb-threatening injuries. Associated undiagnosed vascular injury can lead to prolonged limb ischemia, necessitating amputation. Knee dislocations represent 0.001% to 0.013% of all orthopedic injuries. However, their incidence is underreported, as almost 50% of knee dislocations spontaneously reduce at the scene, before arrival to the emergency department, or are misdiagnosed. Knee dislocations are more commonly reported in men than women, with a ratio of 4:1. Obesity is an independent risk factor for sustaining this injury from an ultralow energy mechanism of injury. […] The outcomes are good for most patients with knee dislocations who obtain prompt management. A chronically unstable and painful knee is common when diagnosis and treatment are delayed.

• #18

  https://www.orthobullets.com/trauma/1043/knee-dislocation

  Knee dislocations are high energy traumatic injuries characterized by a high rate of neurovascular injury. […] Incidence: rare (0.02% of orthopedic injuries) likely underreported as approximately 50% self-reduce and are misdiagnosed. […] Demographics: 4:1 male to female ratio. […] Risk factors: morbid obesity is a risk factor for „ultra-low energy” knee dislocations with activities of daily living.

• #19 Knee dislocation – Wikipedia

  https://en.wikipedia.org/wiki/Knee_dislocation

  Knee dislocations are rare: they represent about 1 in 5,000 orthopedic injuries, and about 1 knee dislocation occurs annually per 100,000 people. Males are more often affected than females, and young adults the most often. […] About half of cases are the result of major trauma and about half as a result of minor trauma. […] Knee dislocations are rare, occurring in about 1 per 100,000 people per year.

• #20 Knee dislocation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/knee-dislocation?lang=us

  Knee dislocations are rare, but a significant number have a serious associated neurovascular injury. […] They account for 0.5% of all joint dislocations. Knee dislocations are bilateral in 5% of cases. Traumatic tibiofemoral joint dislocations afflict younger patients with a male predominance (4:1 ratio to females).

• #21 Journal Of Paramedic Practice – Acute multiligament injured or dislocated knee: field assessment and management

  https://www.paramedicpractice.com/content/features/acute-multiligament-injured-or-dislocated-knee-field-assessment-and-management/

  Some have suggested that the trend towards increasing strength and size of athletes in collision sports has increased the number of knee dislocations seen in association with athletic activities (McCoy et al, 1987; Brautigan and Johnson, 2000). […] Spontaneous knee dislocation has also been described in association with morbid (BMI 35) and super morbid (BMI 45) obesity and low energy mechanism of injury. Among reported cases, dislocation occurred due to ground level fall, ambulation on level ground, or when arising from a chair (Hagino et al, 1998; Seenath et al, 2003; Shetty et al, 2005; Peltola et al, 2009).

• #22 Mental and physical health-related quality of life in patients with recurrent patellar dislocations—a generic and disease-specific quality of life questionnaire assessment | Journal of Experimental Orthopaedics | Full Text

  https://jeo-esska.springeropen.com/articles/10.1186/s40634-022-00499-3

  The results confirmed the hypothesis that LPD significantly impacts the physical dimension of generic HRQoL and patients disease-specific QoL when assessed with the SF-36 and the BPII 2.0. When compared to age-equivalent normative data sets, the MCS values were not reduced prior to operative treatment, indicating an overall good mental health status of the investigated patients. […] Quality of life measures remain underreported in studies evaluating outcomes for LPD. However, the need for more research in this field can be derived from a few studies that have used the Knee Osteoarthritis and Outcome Score (KOOS). […] The results of this pilot study indicate that patients with recurrent LPD are generally in good mental health, although physical impairment is striking. Notwithstanding that surgery prevented further patellar dislocations and normalized the generic HRQoL, the disease-specific QoL remained reduced as far as this can be interpreted without population-based data sets.

• #23 Knee Dislocation: Practice Essentials, Prognosis

  https://emedicine.medscape.com/article/1250829-overview

  Knee dislocation is a relatively rare injury but an important one to recognize because coexistent vascular injury, if missed, often leads to limb loss. […] The Nationwide Inpatient Sample identified 2175 patients who had a knee dislocation between 2005 and 2013 in the United States, and a diagnosis of popliteal artery injury was documented in 210 (9.7%) patients. […] The National Trauma Data Bank identified 6454 knee dislocations between 2010 and 2014. A vascular examination was performed in 29%, with a vascular injury documented in 15% and a vascular procedure performed in 10.8%. […] Death was noted in 2.8%. […] A systematic review has demonstrated that some level of sport participation is possible after multiligament knee injuries (MLKIs) for more than half of patients, but returning to preinjury levels of sport after surgical treatment is low, at just 22% to 33%. […] A study of 88 traumatic knee dislocations found those who were injured at a higher velocity were more likely to have additional injuries.

• #24 Congenital Knee Dislocation | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/congenital-knee-dislocation

  CKD incidence has been reported at 1 in 100,000 live births, or, to better conceptualize its rarity, 1% of the incidence of congenital hip dislocation. […] CKD has also been commonly associated with arthrogryposis, myelodysplasia, or syndromes such as Larsen, Ehlers-Danlos, or Beals syndrome.

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