Randon Hall, MD
In-Depth Look at Patrick Mahomes' Patella Dislocation
Updated: Oct 26, 2019
#PatrickMahomes is reported to have a knee injury in tonight's game against the Broncos. By analysis of the on-field video, they appear to reduce the dislocation.
Almost always the patella will dislocate to the outer aspect of the knee and simply applying pressure to the knee cap and straightening the leg will cause the patella to go back into place. Here is a look at a reduction up close.
Source: PEMBlog (YouTube)
Usually occurs as a non-contact injury with a planted foot on the ground. Many times the athlete is shifting directions, where the body is moving in one direction, and the knee is moving in the opposite direction. Usually the athlete will report a "pop". The knee cap will be forcibly shifted out of its groove. The position of a dislocated patella is depicted below. During the dislocation, the knee can sustain damage to the groove, as well as the under surface of the knee cap, where smooth cartilage is found. An impaction injury can also occur when the knee cap strikes the outer portion of the femur.
Evaluation & Return:
X-rays should be obtained to confirm that the knee cap has returned to its proper position and to determine if any fracture has occurred due to the shifting and impact of the knee cap. (see below)
MRI is generally accepted as the appropriate test to make sure there is no cartilage damage. By definition, you will see reported that the MPFL (Medial Patellofemoral Ligament) will be torn.
If articular cartilage is injured typically needs to be repaired which would be season-ending
If no cartilage is injured, but MPFL is torn, basically have two options. One is to allow the knee to heal and return back to play with around a 50% recurrence rate. The other is to repair or reconstruct the MPFL, which also would be season-ending.
Many athletes return to play after patella dislocations, without surgery. The issue is that just as in shoulder dislocations, they tend to reoccur.
If he returns to play this season, expect he will return with a patella stabilizing brace.
Sunrise View X-ray
Sunrise view x-ray of the knee showing the knee cap in the appropriate position within the patellar groove with no associated fractures of the bone seen.