Surgical versus conservative management of patellar re-dislocation: clinical and radiological results at a mid-term follow-up of 5 years

Background: Patellar dislocation accounts for 2–3% of all knee lesions and is the second most common cause traumatic hemarthrosis knee. Proper treatment essential to minimize long term sequelae, such as recurrent dislocation, painful subluxation, osteoarthritis. Aim: The purposes this perspective randomized study were: 1) evaluate mid-term clinical radiological results Elmslie–Trillat procedure patellar re-dislocation; 2) compare results, especially osteoarthritis development, with those non-operative management re-dislocation. Methods: From June 2013 February 2015, 65 patients were admitted our Emergency Department a first episode. All treated non-operatively. When episode occurred within two years, randomly assigned in groups: Group A, surgically Elmslie-Trillat procedure, B, further Knee Society Score (KSS), Lysholm scale Kujala questionnaire administered immediately after re-dislocation at final follow-up. Tangential patella radiographs evaluated patellofemoral graded according Sperner’s classification. Results: mean follow-up was 6.4±1.7 years (range 5-8) A 6.3±2.1 5-9) B. In KSS showed significant differences between pre- post-operatively values (p<0.05). score significantly lower B when compared value At more than 5 five grade classification changed respectively 25% 29% having greater or equal 3. Conclusion: This confirms that safe effective instability, relieving pain inability, reducing recurrence risk. However, it cannot avoid degenerative changes occurring natural evolution dislocation.