Summary

Patella instability in American football players is a dramatic injury, but we have found that nonsurgical treatment can be successful in most cases in returning athletes to good function during the season.

Abstract

54 patellar instability injuries were identified in the NFL from 2000 to 2012, accounting for 0.17% of all injuries.Fifty-four players sustained patellar instability injuries between 2000 and 2012 with 53 (98%) being acute and 1 being recurrent. Seven of the 54 instability injuries were associated with an MCL sprain. The direction of instability in 3/54 injuries was medial and the remainder were lateral. Only 1 player had recurrent instability. Of the 52 remaining acute injuries, 39 were patellar subluxations and 13 were patellar dislocations. Nineteen percent of players with acute injuries underwent surgery. A mean of 44.38±19.82 days were lost to injury after an acute patellar instability event. Increased number of days lost were seen in patients with frank dislocations, and in those who underwent surgery (65.3 days, 21% of subluxation patients, 15% of dislocation patients).

Discussion And Conclusion

Patellar instability injuries are rare in the NFL, but occurred most commonly in football lineman, typically engaged in blocking during passing plays. Subluxations were 3 times more common than dislocations, and were associated with a quicker return to play. A significant number of the athletes (81%) had nonsurgical management with a mean return to sport in <40 days. Athletes who underwent surgery took longer to return to sport, but this may have been related to the severity of injury. In this elite group of athletes, nonoperative management was oftensuccessful; of note, most of these patients were first time dislocators > 22 years old, and who may be at a relatively low risk of recurrence.