Conservative Versus Surgical Management of First Time Patella Dislocations
Columbia University
Summary
There is no consensus regarding whether rehabilitation or surgical management is best for the management of a primary patellar dislocation. Consequently this prospective randomized controlled aims to compare the incidence of recurrent knee dislocations and patient reported outcomes of patients with primary patellar dislocations managed with surgery (medial patellofemoral ligament reconstruction) compared to non-operative management (a standardized rehabilitation protocol, control group).
Description
Long term sequalae of first-time patellar dislocations include recurrent knee instability, osteoarthritis, and a decreased quality of life, and yet there is no consensus on the best management for these patients. Despite an increasing trend toward investigating operative vs non-operative management of primary patellar dislocations, scarce level-1 evidence exists comparing the two treatment modalities. Indeed, the few meta-analyses suggesting improved outcomes of operative treatment for first time patellar dislocations mainly utilize retrospective cohort studies. A randomized-controlled trial o…
Eligibility
- Age range
- 12+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * age 12 and older * patients seen by the Columbia University Shoulder Elbow and Sports Medicine Service * patients who experience a first-time patella dislocation Exclusion Criteria: * coexistent ligament injury or osteochondral fracture necessitating acute surgical intervention * previous knee surgery * knee instability prior to injury * inability or unwillingness to adhere to study participate * lost to follow up
Interventions
- Proceduremedial patellofemoral reconstruction
Surgery to correct dislocated (knocked out of place) knee cap. This surgery anchors the kneecap back into the correct position and supports the kneecap.
- ProcedureNon-operative group
Physical therapy by following a specific regimen.
Location
- Columbia University Irving Medical CenterNew York, New York