Risk factors and time to recurrent patellar dislocations.
This retrospective study attempted to outline incidence rates of recurrent patellar dislocations as well as identify risk factors for the purpose of facilitating optimal management for the achievement of optimal long-term outcomes. The authors confirmed cumulative rates as well identified both anatomic and demographic risk factors.
A non-operative treatment approach after patellar dislocation is commonplace in medical practice, however it involves high recurrence rates. Recent research has focused on identifying risk factors as well as construction of guidelines to optimize medical management.
The current study collected data over a 20-year period and identified a 36% ipsilateral recurrence rate compared to a 5.4% rate for the contralateral side post initial dislocation. The authors identified the presence of trochlear dysplasia, patella alta, increased TT-TG distance, female gender as well as age less than 18 years at first episode of dislocation were associated with increased risk of recurrence.
The use of surgical management post first time dislocation has met with mixed reviews however, have shown decreases in recurrence rates to as little as 1.2% in those with elevated risk. The authors identified the presence of trochlear dysplasia, patella alta, elevated TT-TG distance, and age at time of initial dislocation were associated with decreased time to recurrence, further outlining those at higher risk. They concluded the identification of these variables might be beneficial in guiding those who would benefit from early surgical intervention.
> From: Christensen et al., Am J Sports Med 45 (2017) 2105-2110. All rights reserved to The Author(s). Click here for the online summary.