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First-time patellar dislocation: surgery or conservative treatment?
[trochlear dysplasia]
Primary
patellar
dislocation
injures
the
medial
patellofemoral
ligament
(
MPFL
)
,
the
major
soft
-tissue
stabilizer
of
the
patella
,
which
may
lead
to
recurrent
patellar
instability
.
Recurrent
patellar
dislocation
are
common
and
may
require
surgical
intervention
.
The
variation
in
location
of
injury
of
the
MPFL
and
the
presence
of
an
osteochondral
fracture
produces
challenges
in
clinical
decision
making
between
nonoperative
and
operative
treatment
,
including
the
surgical
modality
,
to
repair
or
reconstruct
the
MPFL
.
Current
evidence
suggests
that
not
all
primary
dislocations
should
undergo
the
same
treatment
.
MPFL
reconstruction
may
theoretically
be
more
reliable
than
repair
,
but
the
optimal
time
to
perform
additional
bony
corrections
is
not
known
.
A
normal
or
minor
dysplastic
patellofemoral
joint
may
be
suitable
for
nonoperative
treatment
,
whereas
a
higher
grade
of
trochlear
dysplasia
or
other
significant
abnormalities
may
benefit
from
surgical
treatment
.
In
this
paper
,
we
present
a
treatment
algorithm
for
primary
patellar
dislocation
.
Diseases
Validation
Diseases presenting
"minor dysplastic patellofemoral joint"
symptom
trochlear dysplasia
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