Skip to main content
SpringerLink
Log in

Influence of Risk Factors in the Natural History

  • Chapter
  • First Online:
Patellofemoral Pain, Instability, and Arthritis

  • 1552 Accesses

Abstract

Understanding the natural history of lateral patellar dislocations (LPD) is to understand the risk of reinjury. There are many elements that may factor in evaluating a “risk equation,” among them sport, age, and level of fitness. However, at the core of evaluating risk is understanding the unique role of one’s own anatomy in the risk of reinjury. This chapter will be a brief review of the present state of the influence of anatomic risk factors in the risk of reinjury after a primary LPD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Colvin AC, West RV. Patellar instability. J Bone Joint Surg Am. 2008;90:2751–62.

    Article  PubMed  Google Scholar 

  2. Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, et al. Epidemiology and natural history of acute patellar dislocation. Am J Sports Med. 2004;32:1114–21.

    Article  PubMed  Google Scholar 

  3. Hsiao M, Owens BD, Burks R, Sturdivant RX, Cameron KL. Incidence of acute traumatic patellar dislocation among active-duty United States military service members. Am J Sports Med. 2010;38:1997–2004.

    Article  PubMed  Google Scholar 

  4. Nietosvaara Y, Aalto K, Kallio PE. Acute patellar dislocation in children: Incidence and associated osteochondral fractures. J Pediatr Orthop. 1994;14:513–5.

    Article  CAS  PubMed  Google Scholar 

  5. Nikku R, Nietosvaara Y, Aalto K, Kallio PE. The mechanism of primary patellar dislocation. Acta Orthop. 2009:1–3.

    Google Scholar 

  6. Askenberger M, Ekstrom W, Finnbogason T, Janarv PM. Occult Intra-articular knee injuries in children with hemarthrosis. Am J Sports Med. 2014;42:1600–6.

    Article  PubMed  Google Scholar 

  7. Buchner M, Baudendistel B, Sabo D, Schmitt H. Acute traumatic primary patellar dislocation: long-term results comparing conservative and surgical treatment. Clin J Sport Med. 2005;15:62–6.

    Article  PubMed  Google Scholar 

  8. Palmu S, Kallio PE, Donell ST, Helenius I, Nietosvaara Y. Acute patellar dislocation in children and adolescents: a randomized clinical trial. J Bone Joint Surg Am. 2008;90:463–70.

    Article  PubMed  Google Scholar 

  9. Smith TO, Song F, Donell ST, Hing CB. Operative versus non-operative management of patellar dislocation. A meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2011;19:988–98.

    Article  PubMed  Google Scholar 

  10. Tompkins MA, Rohr SR, Agel J, Arendt EA. Anatomic patellar instability risk factors in primary lateral patellar dislocations do not predict injury patterns: an MRI-based study. Knee Surg Sports Traumatol Arthrosc. 2018;26:677–84.

    Article  PubMed  Google Scholar 

  11. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc. 1994;2:19–26.

    Article  CAS  PubMed  Google Scholar 

  12. Arendt EA, England K, Agel J, Tompkins MA. An analysis of knee anatomic imaging factors associated with primary lateral patellar dislocations. Knee Surg Sports Traumatol Arthrosc. 2017;25:3099–107.

    Article  PubMed  Google Scholar 

  13. Askenberger M, Arendt EA, Ekstrom W, Voss U, Finnbogason T, Janarv P-M. Medial patellofemoral ligament injuries in children with first-time lateral patellar dislocations: a magnetic resonance imaging and arthroscopic study. Am J Sports Med. 2016;44:152–8.

    Article  PubMed  Google Scholar 

  14. Malghem J, Maldague B. Depth insufficiency of the proximal trochlear groove on lateral radiographs of the knee: relation to patellar dislocation. Radiology. 1989;170:507–10.

    Article  CAS  PubMed  Google Scholar 

  15. Nikku R, Nietosvaara Y, Aalto K, Kallio PE. Operative treatment of primary patellar dislocation does not improve medium-term outcome: a 7-year follow-up report and risk analysis of 127 randomized patients. Acta Orthop. 2005;76:699–704.

    Article  PubMed  Google Scholar 

  16. Ridley TJ, Bremer Hinckel B, Kruckeberg BM, Agel J, Arendt EA. Anatomical patella instability risk factors on MRI show sensitivity without specificity in patients with patellofemoral instability: a systematic review. J ISAKOS. 2016;1:141–52.

    Article  Google Scholar 

  17. Sillanpaa P, Mattila VM, Iivonen T, Visuri T, Pihlajamaki H. Incidence and risk factors of acute traumatic primary patellar dislocation. Med Sci Sports Exerc. 2008;40:606–11.

    Article  PubMed  Google Scholar 

  18. Sillanpää PJ, Mattila VM, Mäenpää H, Kiuru M, Visuri T, Pihlajamaki H. Treatment with and without initial stabilizing surgery for primary traumatic patellar dislocation. A prospective randomized study. J Bone Joint Surg Am. 2009;91:263–73.

    Article  PubMed  Google Scholar 

  19. Zhang Z, Zhang H, Song G. et al. Increased femoral anteversion is associated with inferior clinical outcomes after MPFL reconstruction and combined tibial tubercle osteotomy for the treatment of recurrent patellar instability. Knee Surg Sports Traumatol Arthrosc. 2019. https://doi.org/10.1007/s00167-019-05818-3.

  20. Frings J, Krause M, Akoto R, Wohlmuth P, Frosch KH. Combined distal femoral osteotomy (DFO) in genu valgum leads to reliable patellar stabilization and an improvement in knee function. Knee Surg Sports Traumatol Arthrosc. 2018;26:3572–81.

    Article  PubMed  Google Scholar 

  21. Imhoff FB, Cotic M, Liska F, Dyrna FGE, Beitzel K, Imhoff AB, et al. Derotational osteotomy at the distal femur is effective to treat patients with patellar instability. Knee Surg Sports Traumatol Arthrosc. 2019;27:652–8.

    Article  PubMed  Google Scholar 

  22. Kaiser P, Schmoelz W, Schoettle P, Zwierzina M, Heinrichs C, Attal R. Increased internal femoral torsion can be regarded as a risk factor for patellar instability—a biomechanical study. Clin Biomech (Bristol, Avon). 2017;47:103–9.

    Article  Google Scholar 

  23. Kaiser P, Schmoelz W, Schottle PB, Heinrichs C, Zwierzina M, Attal R. Isolated medial patellofemoral ligament reconstruction for patella instability is insufficient for higher degrees of internal femoral torsion. Knee Surg Sports Traumatol Arthrosc. 2019;27:758–65.

    Article  CAS  PubMed  Google Scholar 

  24. Kearney SP, Mosca VS. Selective hemiepiphyseodesis for patellar instability with associated genu valgum. J Orthop. 2015;12:17–22.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Takagi S, Sato T, Watanabe S, Tanifuji O, Mochizuki T, Omori G, et al. Alignment in the transverse plane, but not sagittal or coronal plane, affects the risk of recurrent patella dislocation. Knee Surg Sports Traumatol Arthrosc. 2018;26:2891–8.

    Article  PubMed  Google Scholar 

  26. Wilson PL, Black SR, Ellis HB, Podeszwa DA. Distal femoral valgus and recurrent traumatic patellar instability: is an isolated varus producing distal femoral osteotomy a treatment option? J Pediatr Orthop. 2018;38:e162–7.

    Article  PubMed  Google Scholar 

  27. Balcarek P, Oberthur S, Hopfensitz S, Frosch S, Walde TA, Wachowski MM, et al. Which patellae are likely to redislocate? Knee Surg Sports Traumatol Arthrosc. 2014;22:2308–14.

    Article  PubMed  Google Scholar 

  28. Arendt EA, Askenberger M, Agel J, Tompkins MA. Risk of redislocation after primary patellar dislocation: a clinical prediction model based on magnetic resonance imaging variables. Am J Sports Med. 2018;46:3385–90.

    Article  PubMed  Google Scholar 

  29. Jaquith BP, Parikh SN. Predictors of recurrent patellar instability in children and adolescents after first-time dislocation. J Pediatr Orthop. 2017;37:484–90.

    Article  PubMed  Google Scholar 

  30. Christensen TC, Sanders TL, Pareek A, Mohan R, Dahm DL, Krych AJ. Risk factors and time to recurrent ipsilateral and contralateral patellar dislocations. Am J Sports Med. 2017;45:2105–10.

    Article  PubMed  Google Scholar 

  31. Steensen RN, Bentley JC, Trinh TQ, Backes JR, Wiltfong RE. The prevalence and combined prevalences of anatomic factors associated with recurrent patellar dislocation: a magnetic resonance imaging study. Am J Sports Med. 2015;43:921–7.

    Article  PubMed  Google Scholar 

  32. Atkin DM, Fithian DC, Marangi KS, Stone ML, Dobson BE, Mendelsohn C. Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6 months of injury. Am J Sports Med. 2000;28:472–9.

    Article  CAS  PubMed  Google Scholar 

  33. Maenpaa H, Lehto MU. Patellar dislocation has predisposing factors. A roentgenographic study on lateral and tangential views in patients and healthy controls. Knee Surg Sports Traumatol Arthrosc. 1996;4:212–6.

    Article  CAS  PubMed  Google Scholar 

  34. Pfirrmann CW, Zanetti M, Romero J, Hodler J. Femoral trochlear dysplasia: MR findings. Radiology. 2000;216:858–64.

    Article  CAS  PubMed  Google Scholar 

  35. Hevesi M, Heidenreich MJ, Camp CL, Hewett TE, Stuart MJ, Dahm DL, et al. The recurrent instability of the Patella score: a statistically based model for prediction of long-term recurrence risk after first-time dislocation. Arthroscopy. 2019;35:537–43.

    Article  PubMed  Google Scholar 

  36. Camp CL, Heidenreich MJ, Dahm DL, Stuart MJ, Levy BA, Krych AJ. Individualizing the tibial tubercle-trochlear groove distance: patellar instability ratios that predict recurrent instability. Am J Sports Med. 2016;44:393–9.

    Article  PubMed  Google Scholar 

  37. Lewallen L, McIntosh A, Dahm D. First-time patellofemoral dislocation: risk factors for recurrent instability. J Knee Surg. 2015;28:303–9.

    Article  PubMed  Google Scholar 

  38. Feller JA. Factors associated with increased risk of recurrence after first-time patellar dislocation: a systematic review and meta-analysis. Am J Sports Med; 2019. accepted for print.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA

    Elizabeth A. Arendt

Authors
  1. Elizabeth A. Arendt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elizabeth A. Arendt .

Editor information

Editors and Affiliations

  1. Lyon-Ortho-Clinic, Lyon, France

    David Dejour

  2. Istituti Ortopedico Rizzoli Clinica, Ortopedica Traumatologica III, Bologna, Italy

    Stefano Zaffagnini

  3. Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA

    Elizabeth A. Arendt

  4. Department of Paediatric Surgery, University of Tampere, Tampere, Finland

    Petri Sillanpää

  5. Clinic Diakonissen LinzOrthopädie & Sportchirurgie Linz, Puchenau, Austria

    Florian Dirisamer

Rights and permissions

Reprints and permissions

Copyright information

© 2020 ESSKA

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Arendt, E.A. (2020). Influence of Risk Factors in the Natural History. In: Dejour, D., Zaffagnini, S., Arendt, E., Sillanpää, P., Dirisamer, F. (eds) Patellofemoral Pain, Instability, and Arthritis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61097-8_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-61097-8_13

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-61096-1

  • Online ISBN: 978-3-662-61097-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation