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Operative vs conservative treatment of traumatic patellar dislocation: results of a prospective randomized controlled clinical trial

Archives of Orthopaedic and Trauma Surgery volume 133, pages 209–213 (2013)Cite this article

Abstract

Introduction

Patellar dislocation is a common knee injury with mainly lateral dislocations, leading to ruptures of the medial patellofemoral ligament in most of the cases. Even though several prognostic factors for patellofemoral instability have been identified so far, the appropriate therapy for patients with patellar dislocation remains a controversial issue. The purpose of this study was to compare the outcome after conservative or operative treatment in patients after first-time patellar dislocation.

Patients and methods

This randomized controlled clinical trial was designed multicentric including patients from six German orthopaedic and trauma departments. Twenty patients with a mean age of 24.6 years with first-time traumatic patella dislocation were included and randomized into either a conservative arm or an operative arm. Plain X-ray images of the knee joint (a.p. and lateral view and tangential view of both patellae) were performed in all cases prior to therapy to exclude osteochondral fragments requiring refixation. An MRI was recommended, but not compulsory. Patients were consulted after 6, 12, and 24 months with a questionnaire including the criteria of the Kujala score, recurrent dislocation, and satisfaction.

Results

The mean Kujala score of the conservative vs operative treatment group was 78.6 vs 80.3 after 6 months (p = 0.842), 79.9 vs 88.9 after 12 months (p = 0.165), and 81.3 vs 87.5 after 24 months (p = 0.339). Redislocation rate after 24 months was 37.5 % in the conservative group and 16.7 % in the operative group (p = 0.347). Due to the small number of patients that could be included, no significant difference between the groups could be detected. We see a tendency towards better results after operative treatment.

Conclusion

Our multicentric prospective randomized controlled trial revealed no significant difference between conservative and operative treatment for patients after first-time traumatic patellar dislocation. However, a tendency towards a better Kujala score and lower redislocation rates for patients with operative treatment was observed. The small number of patients is a limiting factor of the study, leading to results without statistical significance. A meta-analysis including other study′s level I data is desirable for the future.

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Acknowledgments

We greatly acknowledge funding of Ormed-DJO™ for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany

    M. Petri, E. Liodakis, C. Haasper, C. Krettek & M. Jagodzinski

  2. Trauma Department, Traumacenter Murnau, Prof. Küntscher-Str. 8, 82418, Murnau, Germany

    M. Hofmeister

  3. Trauma Department, DRK Hospital, Alte Frankfurter Str. 12, 57627, Hachenburg, Germany

    F. J. Despang

  4. Orthopaedic Surgery Department, University Hospital Friedrichsheim, Marienburg Str. 2, 60528, Frankfurt, Germany

    M. Maier

  5. Trauma Department, University Hospital Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany

    P. Balcarek

  6. Department of Trauma and Reconstructive Surgery, Friederikenstift Hospital Hannover, Humboldt Str 5, 30169, Hannover, Germany

    C. Voigt & H. Lill

  7. Trauma Department, Johannes-Wesling-Hospital, Hans-Nolte-Str. 1, 32429, Minden, Germany

    J. Zeichen

  8. Centre for Clinical Research, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany

    D. Stengel

  9. Trauma Department, Asklepios Hospital St. Georg, Lohmühlen Str. 5, 20099, Hamburg, Germany

    K. H. Frosch

Authors
  1. M. Petri
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  2. E. Liodakis
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  3. M. Hofmeister
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  4. F. J. Despang
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  5. M. Maier
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  6. P. Balcarek
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  7. C. Voigt
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  8. C. Haasper
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  9. J. Zeichen
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  10. D. Stengel
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  11. C. Krettek
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  12. K. H. Frosch
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  13. H. Lill
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  14. M. Jagodzinski
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Corresponding author

Correspondence to M. Petri.

Additional information

This is a multicentric study of the Committee TRAUMA of the AGA-Society for Arthroscopy and Joint Surgery and the Committee Arthroscopy of the German Society for Trauma Surgery (DGU).

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Petri, M., Liodakis, E., Hofmeister, M. et al. Operative vs conservative treatment of traumatic patellar dislocation: results of a prospective randomized controlled clinical trial. Arch Orthop Trauma Surg 133, 209–213 (2013). https://doi.org/10.1007/s00402-012-1639-8

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  • DOI: https://doi.org/10.1007/s00402-012-1639-8

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