Abstract
Introduction: An acute patellar dislocation is a common injury in childhood, involving mainly adolescent patients, with the majority of them being female. Currently, there is no set algorithm for treatment and no "gold standard" procedure.
The aim of our study is to determine the optimal treatment plan for an acute patellar dislocation, based on retrospective clinical review study. Patient group: There were 323 patients enlisted in this retrospective study.
These were treated in years 2006-2011 for an acute patellar dislocation. Their mean age was 15 years (9-18 years).
Girls-to-boys ratio was 2:1. Conservative treatment was advocated in 288 patients and 35 patients were treated surgically on the basis of clinical and X-ray findings.
Clinical results of the treatment methods were evaluated at 2 years after the trauma. Re-dislocation and complication rates were recorded.
Results: In the conservatively treated group, the re-dislocation rate was 22% (64 of 288 patients), with the rate being higher in the 15 and older age group - 28% (55 of 197). In the surgically treated group no re-dislocation was recorded.
No severe complications were recorded in either group. Discussion: There is a higher incidence of re-dislocation in the conservatively treated patients.
The chronic instability of the patella is greatly influenced by biomechanics of the patello-femoral joint, especially Q-angle and patellar dysplasia. Conclusion: Our results support the use of conservative treatment for patients under 15years of age with mild or no patellar dysplasia and produce good results in these patients with minimal risks.
Surgical treatment is more suitable for patients over 15 years of age or with severe patello-femoral dysplasia and is a method of choice in osteochondral fractures. Primary surgical treatment ensures lower rate of re-dislocation.