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Treatment of acute patellar dislocation.

J D Cash1, J C Hughston

  • 1Hughston Orthopaedic Clinic, PC, Columbus, Georgia 31995.

The American Journal of Sports Medicine
|May 1, 1988
PubMed
Summary

Nonoperative treatment of acute patellar dislocations can yield good or excellent results, especially when there is no congenital abnormality of the extensor mechanism. Early evaluation of the unaffected knee is crucial for prognosis.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanics

Background:

  • Acute patellar dislocation is a common knee injury.
  • Treatment options include operative and nonoperative management.
  • Prognosis may be influenced by underlying anatomical factors.

Purpose of the Study:

  • To compare the effectiveness of nonoperative versus operative treatment for initial acute patellar dislocations.
  • To identify factors influencing treatment outcomes.
  • To assess the role of congenital abnormalities in patellar instability.

Main Methods:

  • Retrospective review of 103 knees from 100 patients with acute patellar dislocation over 30 years.
  • Patients categorized into Group I (congenital abnormality in unaffected knee) and Group II (no abnormality).
  • Outcomes assessed based on nonoperative and operative treatment results, with an average 8-year follow-up.

Main Results:

  • Nonoperative treatment yielded good/excellent results in 52% of Group I knees and 75% of Group II knees.
  • Males had a higher incidence of acute dislocation.
  • Recurrence was less common in patients initially dislocating after age 15.

Conclusions:

  • Primary acute traumatic patellar dislocations can be effectively treated nonoperatively.
  • Congenital abnormalities of the extensor mechanism indicate a poorer prognosis.
  • Examination of the uninvolved knee is essential for predicting outcomes in patellar dislocation treatment.

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