Background Lateral patellar dislocation (LPD) frequently causes damage to the knee. Injury patterns and risk factors contributing to such injuries have not yet been examined in detail. Methods We retrospectively analyzed 50 consecutive patients with primary LPD. Two reviewers evaluated the MRI images regarding risk factors for LPD (Dejours classification; Caton-Deschamps Index, CDI; distance from the tibial tuberosity to trochlear groove, TT-TG; trochlear depth, TD) as well as joint damages according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Results 33 male and 17 female patients with a mean age of 23.2 (±9.6) years were included in this study. 52% were classified Dejours ≥ B, 34% had a CDI ≥ 1.3, 22% a TT-TG ≥ 20mm and 52% a TD < 3mm. 49 out of 50 patients (98%) showed abnormalities according to WORMS. The most frequently observed abnormalities were synovitis/effusion (49/50, 98%), bone marrow oedema (44/50, 88%) and cartilage damage (42/50, 84%). Most frequently affected subregions were medial (41/50, 82%) and lateral (31/50, 62%) patella as well as the anterior (43/50, 86%), central (42/50, 84%) and posterior (11/50, 22%) portion of the lateral femoral condyle. There was no significant correlation between any of the examined risk factors and joint damages according to WORMS. Male patients had higher scores regarding total cartilage damage (5.11 vs. 2.56, p = 0.029), total score for the lateral femorotibial joint (3.15 vs. 1.65, p = 0.026) and overall total WORMS score (12.15 vs. 8.29, p = 0.038). Conclusion Risk factors for LPD do not influence the risk of damages to the knee joint after primary LPD. Although LPD is generally known to affect more female than male patients, male patients suffered more severe injuries after primary LPD, particularly of the lateral femorotibial joint. Overall, our results underline the importance of MRI imaging after primary LPD.

Objective: To demonstrate an effective robotic technique to perform rectopexy. To discuss the role of mesh placement in this minimally invasive surgery. To establish the anatomical landmarks to perform a safe and effective pelvic dissection during a robotic rectopexy. Design: Educational video. Settings: An academic hospital. Patients: We present a case of a 61-year-old female who previously failed simple suture rectopexy, and presented for definitive surgical management. Interventions: Robotic anterior and posterior rectopexy. Measurements/Results: Our video demonstrates an effective robotic technique to perform a posterior and anterior rectopexy. Important topics like the proper use of mesh, the placement of the mesh, and the anatomical landmarks for a safe pelvic dissection during this minimally invasive procedure are also discussed. Conclusions: We have demonstrated an effective robotic technique for the treatment of fecal incontinence and full thickness rectal prolapse. The proper use of mesh during minimally invasive rectopexy prevents postoperative complications. We have shown that the robotic transabdominal rectopexy is a safe and reliable procedure.