PATELLAR INSTABILITY

Course overview

PATELLAR DISLOCATIONS ARE COMMON AND REPRESENT 3 PERCENT OF ALL KNEE INJURIES. ADDITIONALLY, THEY ARE A LEADING CAUSE OF KNEE HEMARTHROSIS. PATELLAR DISLOCATION IS A DISTINCT ENTITY FROM A PATELLAR SUBLUXATION BUT OCCURS IN A SPECTRUM OF DISORDERS TERMED PATELLAR INSTABILITY. PATELLAR DISLOCATIONS OCCUR MORE FREQUENTLY IN THE SECOND AND THIRD DECADES OF LIFE. PATIENTS WITH OBESITY, AS WELL AS FEMALE ADOLESCENT ATHLETES, TEND TO HAVE A HIGHER PREDILECTION TO THIS INJURY. PATIENTS UNDER THE AGE OF 16 TEND TO HAVE HIGHER REOCCURRENCE RATES AND ASSOCIATED COMPLICATIONS OF PATELLAR INSTABILITY FOLLOWING PATELLAR DISLOCATION. THE MOST COMMON OCCURRENCES INVOLVE SPORTING ACTIVITIES WITH RAPID DECELERATION AND TWISTING, INCLUDING INTERNAL ROTATION OF THE LEG AFTER THE FOOT HAS BEEN PLANTED. HOWEVER, DISLOCATIONS CAN ALSO OCCUR WITH TRAUMATIC EVENTS SUCH AS DIRECT IMPACT TO A PARTIALLY FLEXED KNEE. THIS ACTIVITY REVIEWS THE CAUSES, PATHOPHYSIOLOGY, AND PRESENTATION OF PATELLAR INSTABILITY AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN ITS MANAGEMENT.