Abstract
Introduction
Patellar dislocation and rupture of the medial patellofemoral ligament (MPFL) are
frequently seen in daily orthopedic practice. Besides initial non-surgical treatment,
surgery and subsequent rehabilitation are crucial for restoring stability in the femoropatellar
joint. This study investigated current rehabilitation strategies after patellar dislocation
because knowledge on this topic has been severely limited so far.
Materials and methods
The current rehabilitation protocols of 42 orthopedic and trauma surgical institutions
were analyzed regarding their recommendations on weight bearing, range of motion (ROM),
and use of movement devices and orthosis. All protocols for conservative treatment
and postoperative rehabilitation after MPFL reconstruction were compared. Descriptive
and statistical analyses were carried out when appropriate.
Results
The different rehabilitation strategies for conservative and surgical treatment after
patellar dislocation showed a tendency towards earlier functional rehabilitation after
surgical MPFL reconstruction than after conservative treatment. Both surgical and
conservative treatment involved initial restrictions in weight bearing, ROM, and use
of movement devices and orthosis at the beginning of rehabilitation. The rehab protocols
showed a significant earlier full weight bearing after surgical MPFL reconstruction
(p > 0.001). Due to the presence of other parameters for early functional treatment,
the absence of an indication for using orthosis (surgical: 44%, conservative: 33%;
p = 0.515) or start of unlimited ROM of the knee (surgical: 4.9 weeks, conservative:
5.7 weeks; p = 0.076) showed by trend an earlier functional strategy after MPFL reconstruction
than after conservative therapy.
Conclusions
Both conservative and surgical treatment after patellar dislocation showed restrictions
in the early phase of the rehabilitation. Earlier functional therapy was more common
after MPFL reconstruction than after conservative treatment. Further clinical and
biomechanical studies on rehabilitation strategies after patellar dislocation are
needed to improve patient care und individualized therapy.
Keywords
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Article info
Publication history
Published online: January 17, 2019
Identification
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© 2018 Published by Elsevier Ltd.
