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[Dislocation and subluxation of the patella]
1Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftlichen Krankenanstalten Bergmannsheil, Bochum.
Der Orthopade
|August 1, 1989
Summary
Adolescent knee dislocations, often from leg malalignments, are treated with functional therapy for subluxations or arthroscopy for dislocations with hemarthrosis. Early treatment of first-time dislocations without cartilage damage has a low recurrence rate.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Pediatric orthopedics
Background:
- Knee instability in adolescents and young adults can stem from leg malalignments, including rotational issues, axis deviations, and extensor mechanism dysfunction.
- These malalignments can lead to subluxations or complete dislocations of the knee joint.
Purpose of the Study:
- To outline the diagnostic and therapeutic approaches for knee subluxations and dislocations in young individuals.
- To emphasize the importance of timely and appropriate treatment to minimize recurrence and prevent long-term damage.
Main Methods:
- Review of current treatment strategies for knee subluxations and dislocations.
- Classification of treatment based on injury type (subluxation vs. dislocation) and presence of hemarthrosis or chondral lesions.
- Evaluation of recurrence rates associated with different treatment modalities.
Main Results:
- Functional therapy is the preferred treatment for knee subluxations.
- Arthroscopy is indicated for dislocations accompanied by hemarthrosis.
- The first-time dislocation without chondral damage, when treated functionally, exhibits a low recurrence rate of approximately 5%.
Conclusions:
- Prompt and appropriate management of initial knee dislocations in adolescents is crucial for preventing recurrent episodes.
- Reconstruction of the extensor mechanism is necessary for recurrent dislocations to avert further chondral damage and long-term joint instability.