Brooks JR, Pitman AG, Lucas P, Cawthorne DP, Wade SWT. Inferior patella dislocation in an elderly patient after a fall: A case report. World J Orthop 2025; 16(12): 111602 [DOI: 10.5312/wjo.v16.i12.111602]
Corresponding Author of This Article
Joshua R Brooks, Department of Orthopaedics, Northern Beaches Hospital, 105 Frenchs Forest Road West, Frenchs Forest 2086, New South Wales, Australia. joshua.brooks767@gmail.com
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Orthopedics
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 18, 2025 (publication date) through Dec 17, 2025
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Publication Name
World Journal of Orthopedics
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2218-5836
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Brooks JR, Pitman AG, Lucas P, Cawthorne DP, Wade SWT. Inferior patella dislocation in an elderly patient after a fall: A case report. World J Orthop 2025; 16(12): 111602 [DOI: 10.5312/wjo.v16.i12.111602]
World J Orthop. Dec 18, 2025; 16(12): 111602 Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.111602
Inferior patella dislocation in an elderly patient after a fall: A case report
Joshua R Brooks, Alex G Pitman, Philip Lucas, Donald P Cawthorne, Stuart W T Wade
Joshua R Brooks, Donald P Cawthorne, Department of Orthopaedics, Northern Beaches Hospital, Frenchs Forest 2086, New South Wales, Australia
Alex G Pitman, Philip Lucas, Stuart W T Wade, Department of Radiology, Northern Beaches Hospital, Frenchs Forest 2086, New South Wales, Australia
Author contributions: Brooks JR and Wade SWT designed the study and completed the literature review; Brooks JR and Cawthorne DP completed the surgery; Pitman AG, Lucas P, and Wade SWT interpreted the imaging; all authors made substantial contributions to writing and revising the manuscript. All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joshua R Brooks, Department of Orthopaedics, Northern Beaches Hospital, 105 Frenchs Forest Road West, Frenchs Forest 2086, New South Wales, Australia. joshua.brooks767@gmail.com
Received: July 3, 2025 Revised: August 4, 2025 Accepted: October 29, 2025 Published online: December 18, 2025 Processing time: 166 Days and 17.5 Hours
Abstract
BACKGROUND
Inferior intra-articular patella dislocation is rare and comprises horizontal (type 1) and the more common vertical (type 2) dislocations in young and elderly patients respectively. In this case report, we describe a case of an elderly patient who presented with a type 2 dislocation after a fall. The mechanisms of inferior patella dislocation, their classification, key imaging features and treatment options are discussed.
CASE SUMMARY
A 75-year-old woman presented with a right knee fixed flexion deformity after a fall. Preoperative imaging confirmed a vertical intra-articular patella dislocation with a femoral trochlear osteochondral defect and lax though grossly intact patella tendon. Closed reduction was performed under general anaesthesia. Knee arthroscopy confirmed the presence of a femoral trochlear osteochondral defect whose edges were subsequently smoothed and there was debridement of scant debris with thorough irrigation of the joint. Postoperative imaging demonstrated anatomical alignment, however, there was a new nondisplaced medial femoral trochlear. The patient however was able to mobilise well in a range of motion brace set at 0-30 degrees and was discharged 1-day post operatively.
CONCLUSION
Inferior patella dislocation is rare and this article highlights its types and imaging features which determine the most appropriate management.
Core Tip: Assessment of inferior patella dislocation should focus on the patella position, any fractures and the condition of the extensor mechanism. Closed reduction is possible in type 2 injuries (vertical orientation from osteophyte locking), however, success is dependent on the depth and size of the osteochondral defect and degree of patella rotation. Open reduction is recommended for type 1 (horizontal type) due to associated soft tissue injury which can be repaired. In type 2 injuries open reduction is recommended with large osteochondral defects requiring smoothing and or debridement, large osteophytes requiring resection or removal of intra-articular loose bodies.
