Does different duration of non-operative immobilization have an effect on the redislocation rate of primary patellar...

Immobilization devices such as plaster splints, casts and braces have been used for first time patellar dislocation (FTPD) in order to prevent redislocation. This study evaluates different non-operative immobilization regimes upon rates of redislocation.

A retrospective cohort study with a study population of 1366 in which 601 subjects under 30years with FTPD were included from three hospitals. Exclusion criteria were osteochondral fracture, ligament injury and subluxation. Subjects were divided into five groups; unknown/none, two weeks of brace, two weeks of brace followed by bandage, four weeks of brace and six weeks of brace with increasing of range of motion. Radiographs were evaluated for trochlear dysplasia (TD), patella alta, trochlear depth and growth zone. Crude analysis and logistic regression adjusted for radiographic assessments, age, gender and rehabilitation was done in STATA® with significance p≤0.05.

Forty-five point eight percent were between 15 and 19years and 51.4% were male. One hundred sixty-three experienced redislocation (27.1%). Logistic regression was performed at 404 subjects and showed that rehabilitation, gender, TD, patella alta, and growth zone had no significant odds ratio (OR) on redislocation. The duration of brace demonstrated no significant OR in reducing redislocation. Subjects between 20 and 29years showed lower OR in redislocation (95% CI) of 0.27 (0.11; 0.64, p=0.003).

This study demonstrated no difference in duration of brace treatment in reducing patella redislocation after FTPD. Rehabilitation and predisposal factors such as TD, trochlear depth, patella alta and open growth zone did not influence the redislocation rate. Increasing age reduced risk of redislocation.