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· DOS Abstracts
Redislocation after conservative treatment of primary
patellar dislocations
Bo Kaewkongnok, Anders Bøvling, Celia Møllenborg, Bjarke Viberg, Lars Blønd
Orthopaedic Surgery , Køge; Orthopaedic Surgery and Traumatology , Odense
University Hospital; Orthopaedic Surgery, Køge
Background:
Primary patellar dislocation should be treated conservatively us-
ing either a immobilizing brace or a plaster splint, except for cases with osteo-
chondral fracture. No studies have yet focused on various treatment regimens
in relation to the duration of immobilization.
Purpose / Aim of Study:
This study compares different conservative treat-
ment regimes after primary patella dislocation measuring the rate of redisloca-
tion.
Materials and Methods:
Retrospective study comparing two cohorts from
two hospitals, having two different conservative treatment protocols. The first
regime consist of 2 weeks 30 degree locked brace and the second regime con-
sist of 6 weeks brace with gradually increasing range of movements after two
weeks. Patients under 30 years having first-time patellar dislocations were in-
cluded. Redislocations, treatment regimens, type of rehabilitation and trochlea
dysplasia and patella alta on radiographs were recorded.
Findings / Results:
458 patients having 475 primary patella dislocations (230
females) with a median age of 17.0 years (IQR 14.9-20.5) were included. Re-
dislocations (or surgery) were recorded for 132 patients with a median re-dis-
location time of 347 days (IQR 170-704). X-ray images suited for measure-
ment showed a dysplasia proportion of 72.9%. A logistic regression analysis
showed that increasing age (OR 0.82, p<0.0001), instruction in VMO exercises
(OR 0.31, p<0.048), and increasing Insall-Salvati index (OR 0.047,p<0.009) all
were preventive of re-dislocations. None of the treatment regimes showed any
statistical significant difference for preventing re-dislocations.
Conclusions:
We found no difference between the two conservative treatment
protocols in respect to the rate of re-dislocation. Increasing age, instructions in
VMO exercises and increasing Insall-Salvati index was found to be preventive
for re-dislocation.
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