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. 2011 Mar;3(2):170-4.
doi: 10.1177/1941738111399237.

A treatment algorithm for primary patellar dislocations

Neel P Jain  1 , Najeeb Khan, Donald C Fithian
Affiliations

A treatment algorithm for primary patellar dislocations

Neel P Jain et al. Sports Health. 2011 Mar.

Abstract

Context: Primary patellar dislocation continues to be a common problem facing clinicians today. These injuries are associated with significant morbidity and a substantial recurrence rate. Myriad operative and nonoperative options have been described to treat these injuries, although the evidence-based literature is sparse.

Evidence acquisition: PubMed was searched from 1970-2010 to identify publications on patellar dislocations, including clinical presentation, natural history, radiographic workup, and treatment.

Results: The initial workup of a patella dislocation includes a history, physical examination, and radiographs. If there is evidence of a displaced osteochondral fragment or hemarthrosis, then magnetic resonance imaging should be obtained. The treatment of first-time patella dislocators has been controversial, and no study has demonstrated a clear benefit to early operative intervention.

Conclusion: First-time patellar dislocations should be treated conservatively unless there is evidence of a displaced osteochondral fragment.

Keywords: patella dislocation; patellofemoral instability; treatment.

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Conflict of interest statement

No potential conflict of interest declared.

Figures

Figure 1.
Figure 1.
Algorithm for the workup and management of a primary patellar dislocation.
Figure 2.
Figure 2.
MRI demonstrating a large hemarthrosis after patella dislocation. This patient also had a displaced osteochondral fragment.
Figure 3.
Figure 3.
MRI demonstrating large displaced osteochondral fragment. Note the bone bruise pattern typical for patella dislocation.
Figure 4.
Figure 4.
A, osteochondral defect in the patella; B, loose osteochondral fragment. C and D, osteochondral fragment fixed with absorbable pins.
See this image and copyright information in PMC

References

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