Abstract
Lateral patellar dislocation is the frequent cause of knee dysfunction in young athletes—with a particularly high risk noted in female soccer players. Although acute surgical management has been explored, nonoperative management remains the mainstay of treatment after first-time dislocation. In the setting of recurrent lateral patellar instability, surgical reconstruction is typically recommended, including MPFL reconstruction with adjuvant bony and soft tissue procedures depending on associated anatomic instability factors. Numerous questions persist regarding optimal immobilization, bracing, taping, and physical therapy rehabilitation regimens. Return to play programs should involve an individualized progression through objective phases supervised by a trained rehabilitation professional. The ultimate goal of management is to minimize recurrence and return athletes to soccer at their previous level of play.
Top Five Evidence Based References
Askenberger M, Janarv P-M, Finnbogason T, Arendt EA (2017) Morphology and anatomic patellar instability risk factors in first-time traumatic lateral patellar dislocations. Am J Sports Med 45(1):50–58
Jaquith BP, Parikh SN (2015) Predictors of recurrent patellar instability in children and adolescents after first-time dislocation. J Pediatr Orthop [E-pub ahead of print 21 Oct 2015]
Magnussen RA, Duffee AR, Kalu D, Flanigan DC (2015) Does early operative treatment improve outcomes of primary patellar dislocation? A systematic review. Curr Orthop Pract 26(3):281–286
Monson J, Arendt EA (2012) Rehabilitative protocols for select patellofemoral procedures and nonoperative management schemes. Sports Med Arthrosc 20(3):136–144
ISAKOS Orthopaedic Sports Medicine Committee, Almquist F, Arendt EA, Coolican M, Doral N, Ernlund L (2012) Guidelines for the evaluation, management and safe return to sport after lateral patellar dislocation or surgical stabilization in the athletic population. Paper presented at the ISAKOS return to play consensus meeting. ISAKOS, London
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Magnussen, R.A., Schmitt, L.C., Arendt, E.A. (2018). Return to Soccer Following Acute Patellar Dislocation. In: Musahl, V., Karlsson, J., Krutsch, W., Mandelbaum, B., Espregueira-Mendes, J., d'Hooghe, P. (eds) Return to Play in Football. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55713-6_48
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