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https://observatorio.fm.usp.br/handle/OPI/2562
Title: | Traumatic Patellar Dislocation Nonoperative Treatment Compared With MPFL Reconstruction Using Patellar Tendon |
Authors: | BITAR, Alexandre Carneiro; DEMANGE, Marco Kawamura; D'ELIA, Caio Oliveira; CAMANHO, Gilberto Luis |
Citation: | AMERICAN JOURNAL OF SPORTS MEDICINE, v.40, n.1, p.114-122, 2012 |
Abstract: | Background: Over the long term, acute patellar dislocations can result in patellar instability, with high recurrence rates after non-operative treatment. Purpose: To compare the results of operative (reconstruction of the medial patellofemoral ligament [MPFL]) versus nonoperative treatment of primary patellar dislocation. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Thirty-nine patients (41 knees) (mean age, 24.2 years; range, 12-38 years) with acute patellar dislocation were randomized into 2 groups. One group was treated nonoperatively with immobilization and physiotherapy, the other was treated surgically with MPFL reconstruction; both groups were evaluated with minimum follow-up of 2 years. The Kujala questionnaire was applied to assess pain and quality of life, and recurrence was evaluated. Pearson chi(2) or Fisher exact test was used in the statistical evaluation. Results: The statistical analysis showed that the mean Kujala score was significantly lower in the nonoperative group (70.8), when compared with the mean value of the surgical group (88.9; P = .001). The surgical group presented a higher percentage of ""good/excellent"" results (71.43%) on the Kujala score when compared with the nonoperative group (25.0%; P = .003). The nonoperative group presented a large number of recurrences and subluxations (7 patients; 35% of cases), whereas there were no reports of recurrences or subluxations in the surgical group. Conclusion: Treatment with MPFL reconstruction using the patellar tendon produced better results, based on the analyses of posttreatment recurrences and the better final results of the Kujala questionnaire after a minimum follow-up period of 2 years. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MOT Artigos e Materiais de Revistas Científicas - HC/IOT Artigos e Materiais de Revistas Científicas - LIM/41 |
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