Epidemiology and Natural History of Acute Patellar Dislocation

Author:

Fithian Donald C.1,Paxton Elizabeth W.1,Stone Mary Lou1,Silva Patricia2,Davis Daniel K.1,Elias David A.3,White Lawrence M.3

Affiliation:

1. Southern California Permanente Medical Group, San Diego, California

2. Children's Hospital of San Diego, San Diego, California

3. Department of Medical Imaging, Mount Sinai Hospital, New York, New York, University Health Network, University of Toronto, Toronto, Canada

Abstract

Background The goals of this study were to (1) define the epidemiology of acute patellar dislocation, (2) determine the risk of subsequent patellar instability episodes (subluxation and/or redislocation) during the study period, and (3) identify risk factors for subsequent instability episodes. Study Design Prospective cohort study. Methods The authors prospectively followed 189 patients for a period of 2 to 5 years. Historical data, injury mechanisms, and physical and radiographic measurements were recorded to identify potential risk factors for poor outcomes. Results Risk was highest among females 10 to 17 years old. Patients presenting with a prior history of instability were more likely to be female (P < .05) and were older than first-time dislocation patients (P < .05). Fewer first-time dislocators (17%) had episodes of instability during follow-up than patients with a previous history of instability (49%) (P < .01). After adjusting for demographics, patients with a prior history had 7 times higher odds of subsequent instability episodes during follow-up than first time dislocators (adjusted odds ratio = 6.6, P < .001). Conclusions Patellar dislocators who present with a history of patellofemoral instability are more likely to be female, are older, and have greater risk of subsequent patellar instability episodes than first-time patellar dislocators. Risk of recurrent patellar instability episodes in either knee is much higher in this group than in first-time dislocators.

Publisher

SAGE Publications

Subject

Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine

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