Acute Lateral Patellar Dislocation in Adults
Patellar instability is one of the most common problems of the knee affecting young people. The majority of cases of patellar dislocation can be reduced with gentle medial force on the patellar and extension of the knee. In a recent systematic review, no differences were found in terms of redislocation with nonoperative treatment in comparison with the natural history of the injury. All nonoperative treatments assessed showed good patient-reported results, despite the type of treatment used. There is no consensus about the time of nonoperative treatment and the rehabilitation protocol. In recent years, there is a slight evidence that supports close-chain exercises of quadriceps and gluteus and early weight bearing over open-chain exercises. In recent years, there is a slight evidence for operative treatment in first-time dislocations over nonoperative treatment. However, there is not a gold standard surgical procedure for addressing patellar dislocation, and more than 100 different techniques have been published. Medial repair is no longer advised for the treatment of first-time patellar dislocation. Medial patellofemoral ligament reconstruction has gained popularity in the last years. It has the advantage of addressing injuries affecting femoral attachment of the ligament while providing a strong, anatomic, and reliable reconstruction. However, it is not used routinely for the treatment of an acute dislocation.
KeywordsPatellar dislocation Lateral Adults Diagnosis Treatment
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