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Background:Injury incidence rates are commonly reported using either a time-based denominator, such as injuries per 1000 player hours, or an event-based denominator, such as injuries per 1000 athletic exposures. Unless researchers give very detailed baseline information on their study population, it is not possible to convert between these units. We previously observed an apparent geographic split in reporting injury incidence rates between American and non-American researchers. for studies reporting injury risk or incidence during organized sporting events. For each article, the following information was recorded: journal, geographic location of the senior author, method of injury reporting (risk or incidence), incidence rate reporting method (time-based vs. event-based), sports studied, event types included (practice, game/match, or both), injury types reported. Results:A total of 109 articles that reported injury risk or rate were identified. Seventy-four articles reported injury incidence. Twenty-five of the 74 articles reporting injury incidence were written by American researchers, and 92% of these utilized an event-based denominator. Forty-five of the 49 (92%) articles reporting injury incidence written by non-American authors utilized a time-based denominator. Conclusions:Over the last five years, American researchers have chosen to report rates in terms of injuries per athletic exposure, while non-American researchers have preferred time-based rate reporting. Standardization of reporting measures would facilitate crosssport comparisons of injury rates and metaanalyses of existing studies.

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Context:Acute lateral patellar dislocation is a common injury sustained by athletes, and often requires several months to recover and return to play.Objective:To describe a novel protocol for the treatment of acute lateral patellar dislocation that returns patients to play far sooner than traditional treatment protocols.Design:Case series and review of the literature.Setting:Division I NCAA institution.Patients:Two collegiate athletes who sustained first-time acute lateral patellar dislocations.Interventions:Traditional standard of care for acute lateral patellar dislocation after reduction involves 1–7 weeks of immobilization in full extension. Knee stiffness commonly results from this method, and return to full activity typically takes 2–4 months. We used a protocol involving immobilization in maximal flexion for 24 hr, with early aggressive range of motion and quadriceps strengthening in the first week after injury.Main Outcome Measures:Time to return to play.Results:Immediate on-site reduction of the patella followed by 24 hr of immobilization in maximal knee flexion was performed. Following an accelerated rehabilitation regimen, patients were able to return to sport an average of 3 days postinjury. Neither patient has experienced a recurrent dislocation.Conclusions:Our protocol is based on anatomic studies demonstrating reduced tension on the medial patellofemoral ligament, reduced hemarthrosis, and reduced soft tissue swelling in maximal knee flexion. This method apparently bypasses the knee stiffness and deconditioning commonly seen with traditional nonoperative regimens, allowing return to sport weeks or months sooner.