Knee dislocation with concomitant patellofemoral dislocation: A systematic review

Background: There is no consensus treatment for knee dislocations with associated patellar dislocation. This systematic review provides an overview of current treatments and the authors preferred treatment algorithm. Knee dislocation with concomitant patellar dislocation is a rare occurrence and there is no standard of care for these injuries. This review seeks to provide a systematic review of literature and a proposed treatment algorithm for this injury pattern. Methods: A systematic review was performed following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using the PubMed, MEDLINE, and Cochrane databases in July 2024. Studies were assessed for human patients who sustained a knee dislocation with concomitant patellar dislocation. Results: The literature search yielded 288 titles and abstracts to be screened. Of the 288 articles, 281 titles and abstracts were excluded. Ultimately six full text articles were included. There were three case reports/series of acute knee dislocation with associated patellar dislocation and there were three case reports of chronic knee dislocation with associated patellar dislocation. In all studies, patellar instability was addressed surgically regardless of patient risk factors. Conclusion: Knee dislocation with associated patellar dislocation is a rare occurrence, but in general can be treated with the standard of care for a knee dislocation and then an assessment of risk factors for consideration of MPFL repair or reconstruction. Level of evidence: Level 4- systematic review of case reports and case series.