Approach to Patellar Dislocation Treatment: Review and Prospects.

Area of Science:

• Orthopedics and Sports Medicine
• Biomechanics
• Musculoskeletal Research

Background:

• Lateral patellar dislocation (LPD) presents complex etiological challenges in musculoskeletal medicine.
• Anatomical risk factors, including trochlear dysplasia (TD), patella alta, and elevated tibial tubercle-trochlear groove (TT-TG) distance, are critical in LPD.
• Trochlear dysplasia is identified as the most significant anatomical risk factor for LPD.

Purpose of the Study:

• To emphasize the importance of risk assessment and predictive modeling for patient counseling in LPD.
• To explore the controversies and indications for combined surgical procedures versus isolated interventions for LPD.
• To highlight the need for a deeper understanding of anatomical factor interplay for optimizing surgical strategies and outcomes in LPD.

Main Methods:

• Review of existing literature on anatomical risk factors and surgical management of LPD.
• Analysis of predictive models for risk stratification in LPD patients.
• Discussion of current controversies regarding combined surgical approaches (TTO, DDFO, LRR with MPFLR) versus isolated MPFLR.

Main Results:

• Risk assessment models are recommended for identifying high-risk LPD cases suitable for early surgical intervention.
• Combined surgical approaches are indicated for cases with substantial anatomical risk factors.
• Isolated medial patellofemoral reconstruction (MPFLR) may be sufficient for LPD cases with milder risk factors.

Conclusions:

• Individualized treatment strategies for LPD require a comprehensive understanding of the interaction between anatomical factors.
• Higher-quality clinical research and biomechanical modeling are essential for advancing LPD treatment.
• Meticulous patient selection is crucial for optimizing outcomes with combined surgical procedures in LPD management.