TY - JOUR

T1 - Trochlea dysplasia, increased TT-TG distance and patella alta are risk factors for developing first-time and recurrent patella dislocation

T2 - a systematic review

AU - Danielsen, Oddrún

AU - Poulsen, Turið Akraberg

AU - Eysturoy, Niclas Højgaard

AU - Mortensen, Elinborg Sólbjørg

AU - Hölmich, Per

AU - Barfod, Kristoffer Weisskirchner

N1 - Publisher Copyright: © 2023, The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

PY - 2023

Y1 - 2023

N2 - Purpose: The aim of the study was to perform a systematic review and best knowledge synthesis of the present literature concerning biomechanical risk factors for developing first-time and recurrent patella dislocation. Methods: The study was performed as a systematic review following PRISMA guidelines. PubMed and EMBASE were systematically searched. Studies investigating participants with risk factors for first-time as well as recurrent patella dislocation were included. The records were screened, and data extracted independently by two researchers supervised by a third independent assessor. The study was registered in PROSPERO. Results: A total of 6233 records were screened, and 50 studies met the inclusion criteria. The biomechanical risk factors: trochlear dysplasia, increased tibial tuberosity–trochlear groove distance (TT-TG), and patella alta were found to be statistically significantly associated with patella dislocation in several publications and were thus recognized as risk factors for patella dislocation. The soft-tissue stabilizers: longer and thinner MPFL ligament, increased number of type 2C and decreased number of type 1 muscle fibers, and joint laxity were found to be statistically significantly associated with patella dislocation in a few publications, but due to limited evidence, no conclusion was made on this matter. Conclusion: There is strong evidence in the literature that abnormalities of bony stabilizers, trochlear dysplasia, increased TT–TG distance, and patella alta are risk factors for patella dislocation. There is less evidence that soft-tissue stabilizers are risk factors. The study emphasizes the importance of a thorough investigation of bony stabilizers in clinical decision-making. Level of evidence: Level IV.

AB - Purpose: The aim of the study was to perform a systematic review and best knowledge synthesis of the present literature concerning biomechanical risk factors for developing first-time and recurrent patella dislocation. Methods: The study was performed as a systematic review following PRISMA guidelines. PubMed and EMBASE were systematically searched. Studies investigating participants with risk factors for first-time as well as recurrent patella dislocation were included. The records were screened, and data extracted independently by two researchers supervised by a third independent assessor. The study was registered in PROSPERO. Results: A total of 6233 records were screened, and 50 studies met the inclusion criteria. The biomechanical risk factors: trochlear dysplasia, increased tibial tuberosity–trochlear groove distance (TT-TG), and patella alta were found to be statistically significantly associated with patella dislocation in several publications and were thus recognized as risk factors for patella dislocation. The soft-tissue stabilizers: longer and thinner MPFL ligament, increased number of type 2C and decreased number of type 1 muscle fibers, and joint laxity were found to be statistically significantly associated with patella dislocation in a few publications, but due to limited evidence, no conclusion was made on this matter. Conclusion: There is strong evidence in the literature that abnormalities of bony stabilizers, trochlear dysplasia, increased TT–TG distance, and patella alta are risk factors for patella dislocation. There is less evidence that soft-tissue stabilizers are risk factors. The study emphasizes the importance of a thorough investigation of bony stabilizers in clinical decision-making. Level of evidence: Level IV.

KW - Acute patella dislocation

KW - Anatomical risk factors

KW - Biomechanical risk factors

KW - Knee

KW - Recurrent patella dislocation

KW - Risk factors

U2 - 10.1007/s00167-022-07255-1

DO - 10.1007/s00167-022-07255-1

M3 - Review

C2 - 36854995

AN - SCOPUS:85149652970

VL - 31

SP - 3806

EP - 3846

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 9

ER -