Results of Conservative Treatment of First Time Acute Lateral Patella Dislocation

Abstract

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.