First-Time Patellofemoral Dislocation: Risk Factors for Recurrent Instability

Laura Lewallen, Amy McIntosh, Diane Dahm

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Patellofemoral instability is a complex problem, which can be difficult to manage. The purpose of this study was to describe the demographics of patients with a first-time patellofemoral dislocation, and identify risk factors for recurrent instability. This was a single institution, institutional review board-approved, retrospective review of >2,000 patients with a patellar dislocation between 1998 and 2010. Inclusion criteria are as follows: (1) no prior history of patellofemoral subluxation or dislocation of the affected knee; (2) X-rays within 4 weeks of the initial instability episode; and (3) a dislocated patella requiring reduction, or history/findings suggestive of acute patellar dislocation (effusion/hemarthrosis, tenderness along the medial parapatellar structures, and apprehension with lateral patellar translation). Clinical records and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati indices were used to evaluate patella alta. Trochlear dysplasia was assessed using the Dejour classification system. Skeletal maturity was graded based on the distal femoral and proximal tibial physes, using one of the following categories: open, closing, or closed. Three hundred twenty-six knees (312 patients) met the aforementioned criteria. There were 145 females (46.5%) and 167 males (53.5%), with an average age of 19.6 years (range, 9-62 years). Thirty-five patients (10.7%) were treated with surgery after the initial dislocation. All others were initially managed nonoperatively. Of the 291 patients managed nonoperatively, 89 (30.6%) had recurrent instability, 44 (49.4%) of which eventually required surgery. Several risk factors for recurrent instability were identified, including younger age (p 

Original languageEnglish (US)
Pages (from-to)303-309
Number of pages7
JournalThe journal of knee surgery
Volume28
Issue number4
DOIs
StatePublished - Aug 1 2015

Fingerprint

Patellar Dislocation
Patella
Knee Dislocation
Hemarthrosis
Research Ethics Committees
Thigh
Knee
History
X-Rays
Demography

ASJC Scopus subject areas

  • Medicine(all)

Cite this

First-Time Patellofemoral Dislocation : Risk Factors for Recurrent Instability. / Lewallen, Laura; McIntosh, Amy; Dahm, Diane.

In: The journal of knee surgery, Vol. 28, No. 4, 01.08.2015, p. 303-309.

Research output: Contribution to journalArticle

@article{5724bef93742428aabb774434b4d6ced,
title = "First-Time Patellofemoral Dislocation: Risk Factors for Recurrent Instability",
abstract = "Patellofemoral instability is a complex problem, which can be difficult to manage. The purpose of this study was to describe the demographics of patients with a first-time patellofemoral dislocation, and identify risk factors for recurrent instability. This was a single institution, institutional review board-approved, retrospective review of >2,000 patients with a patellar dislocation between 1998 and 2010. Inclusion criteria are as follows: (1) no prior history of patellofemoral subluxation or dislocation of the affected knee; (2) X-rays within 4 weeks of the initial instability episode; and (3) a dislocated patella requiring reduction, or history/findings suggestive of acute patellar dislocation (effusion/hemarthrosis, tenderness along the medial parapatellar structures, and apprehension with lateral patellar translation). Clinical records and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati indices were used to evaluate patella alta. Trochlear dysplasia was assessed using the Dejour classification system. Skeletal maturity was graded based on the distal femoral and proximal tibial physes, using one of the following categories: open, closing, or closed. Three hundred twenty-six knees (312 patients) met the aforementioned criteria. There were 145 females (46.5{\%}) and 167 males (53.5{\%}), with an average age of 19.6 years (range, 9-62 years). Thirty-five patients (10.7{\%}) were treated with surgery after the initial dislocation. All others were initially managed nonoperatively. Of the 291 patients managed nonoperatively, 89 (30.6{\%}) had recurrent instability, 44 (49.4{\%}) of which eventually required surgery. Several risk factors for recurrent instability were identified, including younger age (p ",
author = "Laura Lewallen and Amy McIntosh and Diane Dahm",
year = "2015",
month = "8",
day = "1",
doi = "10.1055/s-0034-1398373",
language = "English (US)",
volume = "28",
pages = "303--309",
journal = "Journal of Knee Surgery",
issn = "1538-8506",
publisher = "Thieme Medical Publishers",
number = "4",

}

TY - JOUR

T1 - First-Time Patellofemoral Dislocation

T2 - Risk Factors for Recurrent Instability

AU - Lewallen, Laura

AU - McIntosh, Amy

AU - Dahm, Diane

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Patellofemoral instability is a complex problem, which can be difficult to manage. The purpose of this study was to describe the demographics of patients with a first-time patellofemoral dislocation, and identify risk factors for recurrent instability. This was a single institution, institutional review board-approved, retrospective review of >2,000 patients with a patellar dislocation between 1998 and 2010. Inclusion criteria are as follows: (1) no prior history of patellofemoral subluxation or dislocation of the affected knee; (2) X-rays within 4 weeks of the initial instability episode; and (3) a dislocated patella requiring reduction, or history/findings suggestive of acute patellar dislocation (effusion/hemarthrosis, tenderness along the medial parapatellar structures, and apprehension with lateral patellar translation). Clinical records and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati indices were used to evaluate patella alta. Trochlear dysplasia was assessed using the Dejour classification system. Skeletal maturity was graded based on the distal femoral and proximal tibial physes, using one of the following categories: open, closing, or closed. Three hundred twenty-six knees (312 patients) met the aforementioned criteria. There were 145 females (46.5%) and 167 males (53.5%), with an average age of 19.6 years (range, 9-62 years). Thirty-five patients (10.7%) were treated with surgery after the initial dislocation. All others were initially managed nonoperatively. Of the 291 patients managed nonoperatively, 89 (30.6%) had recurrent instability, 44 (49.4%) of which eventually required surgery. Several risk factors for recurrent instability were identified, including younger age (p 

AB - Patellofemoral instability is a complex problem, which can be difficult to manage. The purpose of this study was to describe the demographics of patients with a first-time patellofemoral dislocation, and identify risk factors for recurrent instability. This was a single institution, institutional review board-approved, retrospective review of >2,000 patients with a patellar dislocation between 1998 and 2010. Inclusion criteria are as follows: (1) no prior history of patellofemoral subluxation or dislocation of the affected knee; (2) X-rays within 4 weeks of the initial instability episode; and (3) a dislocated patella requiring reduction, or history/findings suggestive of acute patellar dislocation (effusion/hemarthrosis, tenderness along the medial parapatellar structures, and apprehension with lateral patellar translation). Clinical records and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati indices were used to evaluate patella alta. Trochlear dysplasia was assessed using the Dejour classification system. Skeletal maturity was graded based on the distal femoral and proximal tibial physes, using one of the following categories: open, closing, or closed. Three hundred twenty-six knees (312 patients) met the aforementioned criteria. There were 145 females (46.5%) and 167 males (53.5%), with an average age of 19.6 years (range, 9-62 years). Thirty-five patients (10.7%) were treated with surgery after the initial dislocation. All others were initially managed nonoperatively. Of the 291 patients managed nonoperatively, 89 (30.6%) had recurrent instability, 44 (49.4%) of which eventually required surgery. Several risk factors for recurrent instability were identified, including younger age (p 

UR - http://www.scopus.com/inward/record.url?scp=84973431932&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84973431932&partnerID=8YFLogxK

U2 - 10.1055/s-0034-1398373

DO - 10.1055/s-0034-1398373

M3 - Article

C2 - 25633361

AN - SCOPUS:84973431932

VL - 28

SP - 303

EP - 309

JO - Journal of Knee Surgery

JF - Journal of Knee Surgery

SN - 1538-8506

IS - 4

ER -