Patella dislocation: an online systematic video analysis of the mechanism of injury

Abstract

Background The mechanism of injury (MoI) for a patellar dislocation has not been fully established. The aim of this study was to use systematic video analysis to determine the MoI of a patella dislocation. Methods A systematic search was conducted of three video sharing websites and three popular search engines to identify videos demonstrating a patellar dislocation. Videos were reviewed by three surgeons trained in systematic video analysis, who commented on the position of the lower limb and the situation in which the injury occurred. The results were reviewed to build a consensus of the MoI for each video. Statistical analysis was conducted for interobserver agreement (p < 0.05). Results Initial search yielded 603 videos with 13 meeting the inclusion criteria. The injuries were sustained performing a sporting activity (n = 9) or whilst dancing (n = 4). The injury was predominantly sustained during a non-contact situation (n = 10). The most common mechanism was an unbalanced individual with a flexed hip sustaining a valgus force to their flexed knee with the tibia externally rotated. Conclusions This study provides some insight into the MoI for a patellar dislocation and the findings may assist in developing injury prevention programmes and rehabilitation protocols as well as guiding future research.

Injury mechanism of knee medial collateral ligament: An online systematic video analysis

“…[8,12] Video analysis in determining the injury mechanism may reveal deficiencies or mislead the mechanisms specified by the previously determined theoretical models. [10,11] Since the present study is the first video analysis study on MCL injury mechanisms in the literature, it provides valuable information. The MCL is the main medial stabilizer against valgus stress in the knee and provides resistance against external rotational trauma of the lower extremity.…”

“…However, video analysis of injuries reported on YouTube is an accepted method used to identify different injuries. [10,11] Another shortcoming can be listed as the limitations in video analysis. Since the videos are uploaded by different people and/or for different purposes, the video quality and camera angles, the distance the image was taken from, and the number of views obtained from different angles were not the same.…”

“…This methodology has previously been used in recent research. [10,11] The injury mechanism was analyzed into two categories non-contact and contact. Contact injuries, on the other hand, were divided into direct and indirect contact injuries.…”

Challenging the mechanism of distal biceps tendon rupture using a video analysis study

“…Similar studies using video analysis have challenged our thoughts regarding both knee and elbow instability for instance. [9][10][11] Clinicians may feel that mechanism of injury is irrelevant once a DBTR has been diagnosed; however, we feel our findings are potentially important for both injury prevention and rehabilitation. For instance, from our results, we would strongly recommend against a supinated forearm grip during powerlifting disciplines and avoidance of trying to 'lift' the bar with the forearm but to concentrate on initiating power from the legs and back muscles, as per the correctly taught technique.…”

“…The availability of social media and online resources has provided new insights into injury mechanism and has been used by several authors to challenge traditional thinking about other orthopaedic injuries. [9][10][11] A number of videos depicting DBTR during powerlifting and other activities are available on open access media, providing the opportunity for systematic analysis.…”