Incidence and Risk Factors of Acute Traumatic Primary Patellar Dislocation

Sillanpää, Petri; Mattila, Ville M.; Iivonen, Tuomo; Visuri, Tuomo; Pihlajamäki, Harri

doi:10.1249/mss.0b013e318160740f

Cited by 251 publications

(240 citation statements)

References 32 publications

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“…First, it has been previously shown that some hereditary traits, developmental factors and personal characteristics such as family history of patellar dislocation, structural abnormalities, female sex and a body mass index of greater than 25 are associated with increased risk of patellar instability [20][21][22]. Hence, one could conclude that both symptomatic and asymptomatic knees of patients with unilateral patellar instability were predisposed to dislocations.…”

Section: Discussionmentioning

confidence: 99%

Value of CT scan-assessed tibial tuberosity–trochlear groove distance in identification of patellar instability

Mohammadinejad

Shekarchi

2016

Radiol med

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The findings of the current study are not in favor of considering TTTG distance independently in decision-making for surgical interventions. However, greater TTTG in both asymptomatic and symptomatic knees of patients compared to controls indicates that this measure could still be considered as an indicator of knee instability and even the need for surgery if considered in addition to other factors.

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Section: Discussionmentioning

confidence: 99%

Value of CT scan-assessed tibial tuberosity–trochlear groove distance in identification of patellar instability

Mohammadinejad

Shekarchi

2016

Radiol med

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“…The estimated incidence of patellar dislocation is between 7 [2] to 77 per 100,000 people per year [3], with a marginally greater incidence in females [2,4]. The term first-time patellar dislocation (FTPD) represents the first episode that the patella disengages completely from the femoral trochlear.…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation following first-time patellar dislocation: A randomised controlled trial of purported vastus medialis obliquus muscle versus general quadriceps strengthening exercises

et al. 2015

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Purpose: Define whether distal vastus medialis (VM) muscle strengthening improves functional outcomes compared to general quadriceps muscles strengthening following first-time patellar dislocation (FTPD).Methods: Fifty patients post-FTPD were randomised to either a general quadriceps exercise or rehabilitation programme (n=25) or to a specific-VM exercise and rehabilitation regime (n=25).Primary outcome was the Lysholm Knee Score, secondary outcomes included the Tegner Level of Activity Scale, the Norwich Patellar Instability (NPI) Score, and isometric knee extensions strength at various knee flexion ranges of motion. Outcomes were assessed at baseline, six weeks, six months and 12 months.Results: There were statistically significant differences in functional outcome and activity levels through the Lysholm Knee Score and Tegner Level of Activity Scale at 12 months in the general quadriceps exercise group compared to the VM group (p=0.05; 95% CI: -14.0 to 0.0/p=0.04; 95% CI: -3.0 to 0.0). This did not reach a clinically important difference. There was no statistically significant difference between the groups for the NPI Score and isometric strength at any followup interval. The trial experienced substantial participant attrition (52% at 12 months). Conclusions:Whilst there was a statistical difference in Lysholm Knee Score and Tegner Level of Activity Score between general quadriceps and VM exercise groups at 12 months, this may not have necessarily been clinically important. This trial highlights that the recruitment and retention of participants from this population is a challenge and should be considered during the design of future trials in this population. Dislocation -Smith et al (2015) 3 Level of evidence: Therapeutic study, Level I Keywords: Quadriceps; vastus medialis oblique; exercise; patellar dislocation; trial VM versus General Quadriceps following Patellar Dislocation -Smith et al (2015) 4 VM versus General Quadriceps following Patellar IntroductionPatellar dislocation is a disabling musculoskeletal disorder which predominantly affects younger people who are engaged in multi-directional physically active pursuits [1]. The estimated incidence of patellar dislocation is between 7 [2] to 77 per 100,000 people per year [3], with a marginally greater incidence in females [2,4]. The term first-time patellar dislocation (FTPD) represents the first episode that the patella disengages completely from the femoral trochlear. It is sometimes termed primary patellar dislocation [5].Conservative (non-operative) treatment is the treatment of choice for FTPD. Quadriceps strengthening exercises are considered one of the principal management for people following FTPD [6,7]. A United Kingdom (UK) survey of physiotherapy practice has shown that quadriceps strengthening and specific-vastus medialis obliquus (VMO) or distal vastus medialis (VM) muscle strengthening or recruitment exercises were two of the most frequently used interventions for this population [1]. However, there remains controversy rega...

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“…They can be seen with some predisposing conditions such as trochlear dysplasia, patella alta, and extremity alignment disorder, or they can be encountered in normal patellofemoral joint after serious traumas (2).…”

Section: Introductionmentioning

confidence: 99%

Results of Conservative Treatment of First Time Acute Lateral Patella Dislocation

Gül¹,

Çetinkaya²,

Buyukkuscu³

et al. 2017

JAREM

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Objective: Acute patellar dislocations account for 2-3% of all knee injuries. Patients with first-time acute lateral patellar dislocations can be conservatively treated. This study aimed to evaluate the conservative treatment method and clinical outcomes in these patients.Methods: Between 2013 and 2016, patients with traumatic first-time acute patellar dislocation were retrospectively evaluated. Clinically, patients with positive knee joint medial retinaculum tenderness, joint effusion, and positive patellar scaring test results were evaluated. The diagnosis of these patients was supported using direct anteroposterior and lateral knee radiographs and magnetic resonance imaging. The patients' visual pain scale evaluations were performed before and after treatment. Kujala functional assessment scoring was performed only after treatment. Wilcoxon statistical analysis was used to evaluate dependent groups.Results: The mean follow-up period of the patients was 13 months (range, 7-34 months). Three patients were female and 12 were male. Fifteen patient's mean preoperative VAS (Görsel Ağrı Skoru) scores were 8.6 points (range, 7-10), and 1.4 points (range, 0-3) after treatment. The decrease in VAS score was statistically significant (p<0.05). The Kujala score was 87.2 (range, 80-96) in the final evaluations. According to this score, 5 patients were rates as excellent and 10 as good and there were no patients who were worse. Conclusion:The most important aspect of this study is the observation that conservative treatment can achieve good functional outcomes for MPFL tears from bone adherence sites during first-time traumatic patellar dislocation. We conclude that conservative treatment can provide a successful outcome when appropriate patient selection is done.

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Incidence and Risk Factors of Acute Traumatic Primary Patellar Dislocation

Cited by 251 publications

References 32 publications

Value of CT scan-assessed tibial tuberosity–trochlear groove distance in identification of patellar instability

Value of CT scan-assessed tibial tuberosity–trochlear groove distance in identification of patellar instability

Rehabilitation following first-time patellar dislocation: A randomised controlled trial of purported vastus medialis obliquus muscle versus general quadriceps strengthening exercises

Results of Conservative Treatment of First Time Acute Lateral Patella Dislocation

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