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

Oddrún Danielsen, Turið Akraberg Poulsen, Niclas H. Eysturoy, Per Holmich, Kristoffer W. Barfod

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

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.

Keywords: Acute patella dislocation; Anatomical risk factors; Biomechanical risk factors; Knee; Recurrent patella dislocation; Risk factors.

© 2023. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
Original languageEnglish
Article number31
Pages (from-to)3806-3846
JournalKnee Surgery Sports Traumatology Artrhoscopy (KSSTA)
Volume31
DOIs
Publication statusPublished - 1 Feb 2023

Keywords

  • Acute patella dislocation
  • Recurrent patella dislocation
  • Knee
  • Risk factors
  • Anatomical risk factors
  • Biomechanical risk factors

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