Sex-specific Analysis Of Basketball-related Patellar Dislocations: A 20-year Analysis Of National Injury Data

PURPOSE: Basketball-related patellar dislocations are a common presentation to EDs in the US. The aim of this study was to use a national sample to examine mechanisms, distribution, and trends of patellar dislocations. We hypothesized that patellar dislocations will (a) occur more frequently among males and high school age players, and (b) increase during the study period; also that (c) falls will be the most common mechanism of injury, and (d) males will more frequently sustain contact-related patellar dislocations. METHODS: NEISS was queried for basketball-related patellar dislocations presenting to US EDs from January 1, 2003-December 31, 2022. Patient demographics, injury location, and disposition were recorded. The injury mechanism was identified from the provided clinical narrative. RESULTS: We observed a significant increase in patellar dislocations across the study period (p < 0.001). Males demonstrated a significant increase (p < 0.001), but females did not (p = 0.136). The most common mechanism of injury was falling (NE: 5,379. 38.5%) followed by twisting/pivoting (NE: 3,484, 24.9%). Males demonstrated a significantly greater proportion of dislocations from player-to-player contact compared to females (14.2% v. 8.5%, p < 0.001). Left patellar dislocations were more common than right (58.2% v. 41.9%), but the more common laterality differed depending on mechanism of injury. Direct player-to-player knee contact and jumping/landing resulted in significantly higher proportions of left dislocations (p < 0.001), whilst falls had a significantly higher proportion of right patellar dislocations (p < 0.001). CONCLUSION Basketball-related patellar dislocations increased among males between 2003-2022, but not among females. Overall, falls were the most common mechanism of injury. Males sustained a greater proportion of dislocations from player-to-player contact than females. Jumping resulted in a higher proportion of left patellar dislocations, while falls resulted in a higher proportion of right patellar dislocations. CLINICAL RELEVANCE: The burden of patellar dislocations is increasing in incidence in males and more common in youth athletes.