[Functional treatment method following patellar dislocations]

Acute, as well as recurrent, dislocations of the patella often are treated conservatively. However, an increasing number of authors are recommending early surgical treatment for primary, traumatic, as well as congenital, dislocations of the patella. The purpose of this report was to determine, which cases should be treated by operation or conservatively by a specific patellar protection program. This program includes four phases or rehabilitation: Phase I: Antiinflammatory measures (ice, compression and elevation, non steroidal medications), specific exercises (isometrics, straight leg raises with no weight, side leg raises with no weight), active range of motion, passive range of motion with no weights, flexibility of back, hip, hamstrings, quadriceps, ankle, groin and general exercises (swimming, general conditioning and opposite extremity program). Phase II: Continue isometric program, progressive-resistive program with ankle weights, continue flexibility program, lateral step-ups if terminal extension painful, eccentric isometrics if straight leg raises painful, continue swimming, may begin low resistance cycling if motion adequate. Phase III: Isotonic progressive-resistive exercise program, exercise to fatigue using weight or similar equipment (quadriceps, hamstrings, circuit exercises). Phase IV: Slow return to sports to develop specific neuromuscular skills at that sport, continued strength and endurance training. Continue weight machines and a full range of motion, running program, continued flexibility before and after athletic play.