Taping for an Acute and Subacute Patellofemoral Dislocation, Recurrent Subluxation

A primary acute patellofemoral dislocation needs to be managed well to ensure adequate tissue healing. Evidence that surgical intervention is better than conservative management is equivocal, particularly in the skeletally immature individual. Conservative management is less expensive and less invasive, and it may be better at maintaining knee function than surgical intervention. Along with appropriate immobilization, using rigid strapping tape, conservative management should consist of a tailored rehabilitation program to improve dynamic lower limb loading and quadriceps control, so individuals may be able to return to their previous active lifestyle, including their sporting activities.

The initial phase of a primary patellar dislocation, followed by the subacute phase, including recurrent patellar instability.

The first sequence demonstrates how to tape the patella for the first 6 weeks following an acute patellofemoral dislocation. The rigid tape needs to tilt and center the patella in the trochlea, ensuring that the inferior pole does not aggravate the highly nociceptive infrapatellar fat pad. The medial soft tissues are shortened to enhance healing of the elongated tissues. The second sequence demonstrates taping for a subacute dislocation (after 6 weeks) or a recurrent subluxing patella. Firm tape can be applied across the vastus lateralis to minimize lateral patellar displacement, facilitating vastus medialis oblique contraction.

These taping techniques, combined with a guided exercise program focused on specific lower limb training to improve neural patterning, have enabled patients to successfully return to their previous sporting activities. They should still be taped for sports to minimize the incidence of recurrence. The return to sport is gradual, allowing individuals to feel confident. Depending on the amount of contact and pivoting activity in the sport, as well as the severity of the dislocation, it may take 12 months before some are ready to fully return to their sport.

With appropriate initial stabilization of the soft tissues, graduated taping in the subacute or recurrent phase, and a tailored exercise program, individuals who have had an acute dislocation can be effectively rehabilitated so that they can return to their previous activity levels.

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.