TITLE

Acute Patellar Dislocation in Children and Adolescents: A Randomized Clinical Trial

AUTHOR(S)
Palmu, Sauli; Kallio, Pentti E.; Donell, Simon T.; Helenius, Ilkka; Nietosvaara, Yrjänä
PUB. DATE
March 2008
SOURCE
Journal of Bone & Joint Surgery, American Volume;Mar2008, Vol. 90-A Issue 3, p463
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The treatment of acute patellar dislocation in children is controversial. Some investigators have advocated early repair of the medial structures, whereas others have treated this injury nonoperatively. The present report describes the long-term subjective and functional results of a randomized controlled trial of nonoperative and operative treatment of primary acute patellar dislocation in children less than sixteen years of age. Methods: The data were gathered prospectively on a cohort of seventy-four acute patellar dislocations in seventy-one patients (fifty-one girls and twenty boys) younger than sixteen years of age. Sixty-two patients (sixty-four knees) without large (>15 mm) intra-articular fragments were randomized to nonoperative treatment (twenty-eight knees) or operative treatment (thirty-six knees). Operative treatment consisted of direct repair of the damaged medial structures if the patella was dislocatable with the patient under anesthesia (twenty-nine knees) or lateral release alone if the patella was not dislocatable with the patient under anesthesia (seven knees). All but four patients who underwent operative treatment had a concomitant lateral release. The rehabilitation protocol was the same for both groups. The patients were seen at two years, and a telephone interview was conducted at a mean of six years and again at a mean of fourteen years. Fifty-eight patients (sixty-four knees; 94%) were reviewed at the time of the most recent follow-up. Results: At the time of the most recent follow-up, the subjective result was either good or excellent for 75% (twenty- one) of twenty-eight nonoperatively treated knees and 66% (twenty-one) of thirty-two operatively treated knees. The rates of recurrent dislocation in the two treatment groups were 71% (twenty of twenty-eight) and 67% (twenty-four of thirty-six), respectively.
ACCESSION #
31375443

 

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