David Sands Johnson1, Philip Gartside Turner2. 1. Department of Trauma and Orthopaedics, Stockport NHS Foundation Trust, Aspen House, Stepping Hill Hospital, Poplar Grove, Stockport SK2 7JE, United Kingdom of Great Britain and Northern Ireland; School of Health and Society, Mary Seacole Building, University of Salford, Frederick Road Campus, Salford M6 6PU, United Kingdom of Great Britain and Northern Ireland. Electronic address: david.johnson@stockport.nhs.uk. 2. Department of Trauma and Orthopaedics, Stockport NHS Foundation Trust, Aspen House, Stepping Hill Hospital, Poplar Grove, Stockport SK2 7JE, United Kingdom of Great Britain and Northern Ireland; School of Health and Society, Mary Seacole Building, University of Salford, Frederick Road Campus, Salford M6 6PU, United Kingdom of Great Britain and Northern Ireland.
Abstract
BACKGROUND: Little guidance exists on the management of the first-time patellar dislocation. The aim of this article was to review current guidance for management of this condition. METHODS: Recent meta-analyses, systematic reviews and current consensus documents relating to first-time patellar dislocation were sourced. An instructional lecture was then created and delivered at the acute knee injuries session at the British Orthopaedic Association 2019 annual conference, which was presented on behalf of the British Association for Surgery of the Knee. This article has been written based on this lecture. RESULTS: There is a paucity of literature relating to management of the first-time patellar dislocation. Many studies are of poor design, with inadequate follow-up, making it difficult to draw conclusions from them. However, based upon available information and consensus from working groups it is recommended that patients presenting with first-time dislocation should be assessed to ensure they have not sustained an alternative or associated injury that may require surgical intervention, be assessed and counselled for the risk of recurrent dislocation, and be referred for initial conservative treatment. Surgical stabilisation should be reserved for patients with recurrent instability. CONCLUSIONS: Most patients with a first-time patellar dislocation can be managed conservatively, having excluded associated injuries. Due to the poor quality of the literature, care must be taken interpreting the results of studies. It is clear that further research is required in this field. Crown
BACKGROUND: Little guidance exists on the management of the first-time patellar dislocation. The aim of this article was to review current guidance for management of this condition. METHODS: Recent meta-analyses, systematic reviews and current consensus documents relating to first-time patellar dislocation were sourced. An instructional lecture was then created and delivered at the acute knee injuries session at the British Orthopaedic Association 2019 annual conference, which was presented on behalf of the British Association for Surgery of the Knee. This article has been written based on this lecture. RESULTS: There is a paucity of literature relating to management of the first-time patellar dislocation. Many studies are of poor design, with inadequate follow-up, making it difficult to draw conclusions from them. However, based upon available information and consensus from working groups it is recommended that patients presenting with first-time dislocation should be assessed to ensure they have not sustained an alternative or associated injury that may require surgical intervention, be assessed and counselled for the risk of recurrent dislocation, and be referred for initial conservative treatment. Surgical stabilisation should be reserved for patients with recurrent instability. CONCLUSIONS: Most patients with a first-time patellar dislocation can be managed conservatively, having excluded associated injuries. Due to the poor quality of the literature, care must be taken interpreting the results of studies. It is clear that further research is required in this field. Crown
Authors: Reva Y Qiu; Daire W D Fitzpatrick; Dan Cohen; Jeffrey Kay; Mahmoud Almasri; Darren L de Sa Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-07-07 Impact factor: 4.342