Acute and recurrent patellar instability in the young athlete

Patellar instability – Changing beliefs and current trends

“…18 Current dictum is judicious immobilisation using posterior splint for the pain and oedema to subside and begin range of movement exercises at the earliest to prevent stiffness and improve articular cartilage nutrition. 19 Post immobilisation rehabilitation should be directed towards strengthening of VMO and gluteal muscles along with the core muscles. …”

Patellar instability

“…Patella alta, quadriceps dysplasia, abnormal tibial tubercle-trochlear groove (TT-TG) distance and trochlear dysplasia were all found to be independent risk factors for patellar instability 19 . Ligamentous laxity is also a risk factor for patellar instability 22 . Ligamentous laxity allows a larger knee range of motion and greater degrees of ligamentous translation.…”

“…of motion exercises to prevent stiffness and maintain articular cartilage health 22 . Physical therapy is utilised with particular attention to VMO and gluteal strengthening 1,34 .…”

“…Patellar taping has been shown to decrease pain, allow increased quadriceps activity, and improve function following patellar dislocation 1,35 . It has also been shown to improve VMO activity onset, which may improve patellar tracking and subsequent risks of dislocation; however, the mechanism of this remains unknown 22,35 . Mäenpää et al followed 100 patients treated non-operatively for an average of 13 years following an initial dislocation.…”

“…Immobilisation may be recommended for up to 6 weeks for comfort and soft tissue healing 8,22 . As symptoms allow, patients may progress out of immobilisation and begin a range sia play a significant role in patellar instability.…”