The relationship between joint hypermobility and patellar instability: A systematic review

Area of Science:

• Orthopedics
• Rheumatology
• Sports Medicine

Background:

• Hypermobility, characterized by excessive joint movement, is common.
• The link between hypermobility and patellar instability remains unclear.
• This study investigates the association between joint hypermobility and patellar instability risk and treatment outcomes.

Purpose of the Study:

• To determine if joint hypermobility increases the risk of patellar instability.
• To evaluate treatment outcomes for patellar instability in hypermobile patients.

Main Methods:

• A systematic literature search was conducted up to September 7, 2023.
• Included studies compared patellar dislocation prevalence and treatment outcomes in patients with and without hypermobility.
• 18 studies involving 4,391 patients were identified.

Main Results:

• Generalized joint laxity was six times more prevalent in patients with patellar dislocation (64.4% vs 10.9%).
• Surgical interventions for patellar instability in hypermobile patients showed satisfactory outcomes in five studies.
• Medial patellofemoral ligament reconstruction had a higher failure rate in patients with Ehlers Danlos Syndrome (19.1%), linked to hypermobility.

Conclusions:

• Joint hypermobility is a significant risk factor for patellar instability.
• Identifying hypermobile individuals can aid in preventing dislocations and tailoring treatments.
• Ehlers Danlos Syndrome patients with hypermobility may experience poorer surgical outcomes, requiring vigilant post-operative monitoring.