With an incidence of 5.8 per 100,000 per year, patellar dislocations are commonly seen in the emergency department. Surprisingly, there are only a few studies available that focus on the results of the different non-surgical treatment options after first-time patellar dislocation. The aim of this review is to provide an overview of the most recent and relevant studies on the rationales and results of the non-surgical treatment for first-time patellar dislocation.Patellar instability mainly affects young and active patients, with a peak incidence of 29 per 100 000 per year in adolescents. The medial patellofemoral ligament, a main passive restraint for lateral translation of the patella, is torn in lateral patellofemoral dislocations. Treatment of first-time patellar dislocation can be either conservative or surgical.There are two options in conservative management of first-time patellar dislocation: immobilization using a cylinder cast or removable splint, or, second, functional mobilization after applying a brace or patellar tape.The current available literature of conservative treatment after a first-time patellar dislocation is little and of low quality of evidence. Conclusions should be drawn with care, new research focussing on non-surgical treatment is therefore strongly needed. Cite this article: 2019;4:110-114. DOI: 10.1302/2058-5241.4.180016.
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http://dx.doi.org/10.1302/2058-5241.4.180016 | DOI Listing |
Cureus
November 2024
Pharmacy, Kafr El Sheikh Hospital, Kafr El Sheikh, EGY.
Acute first-time traumatic patellar dislocation is a prevalent knee injury, particularly in adolescents, often managed conservatively with knee bracing. Recently, medial patellofemoral ligament (MPFL) reconstruction has gained popularity for its potential benefits in reducing redislocation rates and enhancing functional outcomes. This systematic review and meta-analysis compared the outcomes of MPFL reconstruction versus knee bracing for managing acute first-time traumatic patellar dislocation.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
Department of Orthopaedics, Unit of Musculoskeletal Surgery, Tampere University Hospital, Finland.
Background: After first-time lateral patellar dislocation, 44% to 70% of patients sustain redislocations. Increased femoral anteversion (FA) is considered to result in increased lateralizing forces on the patella, which might predispose one to patellar instability. When recurrent patellar dislocations (RPDs) are bilateral, it is unclear if the FA is even more increased.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
October 2024
Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
J ISAKOS
October 2024
Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA. Electronic address:
Surgery for patellofemoral instability is usually considered in patients with recurrent patellar dislocation and after a first-time patellar dislocation in the presence of either an associated osteochondral fracture or high risk of recurrence due to the presence of several risk factors. Risk factors include demographics such as age, contralateral dislocation, as well as anatomic risk factors (ARF) such as abnormal coronal and rotational alignment, trochlear dysplasia, lateral quadriceps vector, and patella alta. Surgery with soft tissue procedures includes restoring the medial patellar restraints and balancing the lateral side of the joint and can be successful in most patients.
View Article and Find Full Text PDFJ ISAKOS
December 2024
Cleveland Clinic Akron General, 1 Akron General Ave, Akron, OH 44307, USA. Electronic address:
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