Document Title: Atkin-AJSM-Jul00

Article Title: Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6 months of injury

Authors: Dave M. Atkin, Donald C. Fithian, Kent S. Marangi, Mary Lou Stone, et al.

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: July-August 2000.

(Figures included. Reference-denoting numbers appear in the same point size as document text.)

Volume: 28

Issue: 4

Pages: 472-479

Key Words: Knee, patellar dislocation, conservative treatment.

This article looks at nonsurgical rehabilitation after patellar dislocation. The rehabilitation programme examined was a conservative one, and entailed range-of-motion exercises, muscle strengthening, gradual return to activity, and use of patellar-stabilizing braces (neoprene sleeves with patellar-tracking provisions).

ABSTRACT

We prospectively studied the characteristics and early recovery of an unselected population of patients who had acute first-time lateral patellar dislocation. The recovery program used standardized rehabilitation, emphasizing range of motion, muscle strength, and return of function. Patients returned to stressful activities including sports as tolerated when they regained full passive range of motion, had no effusion, and when quadriceps muscle strength was at least 80% compared with the non-injured limb. Seventy-four patients met the enrollment criteria; 37 men and 37 women. The average age was 19.9 years, and pre-injury sports participation was similar to that of ligament-injury patients. Four percent of patients (N = 3) had a history of birth complications, 3% (N = 2) had a history of lower extremity problems as an infant or child, and 9% (N = 7) had a family history of patellar dislocation. Radiographs revealed a 50% incidence (N = 37) of patella altar all patients demonstrated lateral patellar overhang. Patients regained range of motion (mean, 0 degrees to 132 degrees) by six weeks. Sports participation remained significantly reduced throughout the first 6 months after injury, with the greatest limitations in kneeling and squatting. At 6 months, 58% of patients (N = 43) noted limitation in strenuous activities. The patients who had acute primary patellar dislocation were young and active. Most injuries occurred during sports, and few patients had abnormal physical features, contradicting any stereotype of an overweight, sedentary, adolescent girl whose patella dislocates with little or no trauma.

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