First-time Lateral Patellar Dislocation: Evaluation and Management

Jarred K Holt, Bradley J Nelson

Volume 3 | Issue 1 | Jan – Apr 2018 | Page 3-9

Author: Jarred K Holt [1], Bradley J Nelson [1,2]

[1] Department of, TRIAOrthopaedic Center, 8100 Northland Drive, Bloomington, MN 55431,
[2] Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454

Address of Correspondence
Dr. Bradley J Nelson,
Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Suite R200,Minneapolis, MN 55454.
E-mail: ???

Abstract

Lateral patellar dislocation is a common injury affecting a young, athletically active population. These injuries occur as a direct trauma to the knee or as a result of a twisting mechanism on a planted foot. They are typically accompanied by an audible “pop,” acute pain, and substantial swelling. The nature of the injury results in a variety of bony and soft tissue disruptions including medial patellofemoral ligament tears and osteochondral lesions of the femoral trochlea and inferomedial patella. In the acute setting, initial treatment is directed toward obtaining a concentric reduction, though oftentimes, this has already occurred spontaneously following the injury. Further, management decisions are based on a multitude of factors including concomitant injuries and patient anatomic considerations. Historically, the first-time patella dislocations were treated conservatively; however, more recent literature supports operative care in an effort to prevent recurrent instability events. Given an overall lack of compelling evidence to support either treatment option, it is felt that a thorough risk assessment and shared decision-making model should be employed to guide care of the first-time patella dislocation.
Key words: lateral patellar dislocation, evaluation, surgical management

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