Sports Medicine Update – Patellar Dislocations

A brief in the July/August issue of Sports Medicine Update provided an emerging technique for managing patella dislocations. Typically, the patella dislocates laterally with related damage to the medial patellofemoral ligament (MPFL). After reduction, traditional management has included an immobilizer and compression wrap to control the joint effusion and weight bearing as tolerated in full extension.A new technique is suggested that immobilized the knee in 120 degrees of flexion for the first 24 hours after reduction. The theory behind this is that it provides maximum congruency in the PF joint and reduces tension on the MPFL. Application of a 6-inch compression wrap involves twisting the wrap behind the knee so the compression is on the anterior aspect of the thigh and shin; there is not pressure behind the knee. It is similar to how one might do for a quadriceps contusion. This technique is used at the US Naval Academy and a paper on the early results of a study will be published soon.