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Am J Sports Med. 2012 Jan;40(1):114-22. doi: 10.1177/0363546511423742. Epub 2011 Oct 19.

Traumatic patellar dislocation: nonoperative treatment compared with MPFL reconstruction using patellar tendon.

Author information

1
Instituto Vita, São Paulo, SP, Brasil. isabela@vita.org.br

Abstract

BACKGROUND:

Over the long term, acute patellar dislocations can result in patellar instability, with high recurrence rates after nonoperative treatment.

PURPOSE:

To compare the results of operative (reconstruction of the medial patellofemoral ligament [MPFL]) versus nonoperative treatment of primary patellar dislocation.

STUDY DESIGN:

Randomized controlled trial; Level of evidence, 1.

METHODS:

Thirty-nine patients (41 knees) (mean age, 24.2 years; range, 12-38 years) with acute patellar dislocation were randomized into 2 groups. One group was treated nonoperatively with immobilization and physiotherapy, the other was treated surgically with MPFL reconstruction; both groups were evaluated with minimum follow-up of 2 years. The Kujala questionnaire was applied to assess pain and quality of life, and recurrence was evaluated. Pearson χ(2) or Fisher exact test was used in the statistical evaluation.

RESULTS:

The statistical analysis showed that the mean Kujala score was significantly lower in the nonoperative group (70.8), when compared with the mean value of the surgical group (88.9; P = .001). The surgical group presented a higher percentage of "good/excellent" results (71.43%) on the Kujala score when compared with the nonoperative group (25.0%; P = .003). The nonoperative group presented a large number of recurrences and subluxations (7 patients; 35% of cases), whereas there were no reports of recurrences or subluxations in the surgical group.

CONCLUSION:

Treatment with MPFL reconstruction using the patellar tendon produced better results, based on the analyses of posttreatment recurrences and the better final results of the Kujala questionnaire after a minimum follow-up period of 2 years.

PMID:
22016458
DOI:
10.1177/0363546511423742
[Indexed for MEDLINE]

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