Management of traumatic patellar dislocation in a regional hospital in Hong Kong

Abstract

Introduction: The role of surgery for acute patellar dislocation without osteochondral fractures is controversial. The aim of this study is to report the short-term results of management of patellar dislocation in our institute. Methods: Patients who had patella dislocation seen in our institution from January 2011 to April 2014 were managed according to a standardized management algorithm. Pre-treatment and one-year post-treatment International Knee Documentation Committee (IKDC) score, Tegner activity level scale and presence of apprehension sign were analysed. Results: 41 patients were studied. 20 patients were first time dislocators. 21 patients were recurrent dislocators. Among the first time dislocators, there was significant difference between patients receiving conservative treatment and surgical management. The conservative treatment group had 33% recurrent dislocation rate, whereas there were no recurrent dislocations for the surgery group. However, there was no difference in Tegner activity level scale and apprehension sign before and one year after treatment. Among the recurrent dislocators who received surgery, there was significant difference between patients receiving conservative treatment and surgical management. Recurrent dislocation rate was 71% in the conservative treatment group, whereas there were no recurrent dislocations for the surgery group. There was also significant improvement of IKDC score from 67.7 to 80 (p=0.02), and of apprehension sign from 62% to 0% (p<0.01). Conclusions: A management algorithm for patellar dislocation is described. Surgery is preferable to conservative treatment in treating patients suffering from recurrent patellar dislocations, and may be preferable for patients suffering from acute patellar dislocations.