Arthroscopic surgical repair versus conservative treatment of acute patellar dislocations

Includes bibliographical references (pages [29]-33)To determine the effectiveness of nonsurgical and surgical treatments of initial patellar dislocation, 22 patients with the diagnosis of acute patellar dislocation seen during a 4-year period at an outpatient orthopaedic clinic were studied. A total of 23 knees were evaluated with an average patient age of 18.3 years (range, 13 to 37 years) at the time of injury. The length of follow-up averaged 3.1 years (range, 1.1 to 4.7 years). Participants were given the choice of undergoing surgery, which consisted of arthroscopic suturing of the medial retinaculum with arthroscopic lateral release of the lateral retinaculum, or conservative treatment involving rehabilitation of the injured knee. All patients were asked to complete a patient satisfaction survey and return for a follow-up visit to perform a functional knee rating test. In the nonsurgically treated knees there was a 75% (9/12) incidence of good or excellent results. The surgically treated knees had a91%(10/ll) incidence of good or excellent results. The only statistically significant difference (t = 2.42, p = .01) was seen in the amount of time to return to full activity, with the nonsurgical patients (10.8 + 5.8 weeks) returning more quickly than the surgically treated patients (15.3 + 2.7 weeks). According to these results, surgery cannot be recommended for all patients suffering an acute dislocation of the patella.M.S. Ed. (Master of Education