Conservative versus surgical treatment for repair of the medial patellofemoral ligament in acute dislocations of the patella.
OBJECTIVE
The objective of this study was to analyze and compare the results obtained after 2 types of treatment, surgical and conservative, for acute patellar dislocations.


METHODS
We divided 33 patients with acute patellar dislocations into 2 groups. One group with 16 patients underwent conservative treatment (immobilization and subsequent physiotherapy), and the other group with 17 patients underwent surgical treatment. A radiographic examination was performed in the evaluation of the patients to verify predisposing factors for patellofemoral instability, and the Kujala questionnaire was applied with the intention of analyzing the improvement of pain and quality of life. The chi(2) test, t test, and Fisher test were used in the statistical evaluation. A significance level of P < .05 was adopted.


RESULTS
The groups were considered parametric in relation to age and sex. The conservative treatment group exhibited a higher number of recurrent dislocations (8 patients) than the surgical treatment group, which did not have any relapses. In addition, the surgical treatment group obtained a better mean score on the Kujala test (92) than the conservative treatment group (69).


CONCLUSIONS
We conclude that surgical treatment afforded better results. There were no recurrences in the surgical treatment group, but there were 8 recurrences in the conservative treatment group. The mean Kujala score was 92 in the surgical treatment group and 69 in the conservative treatment group.


METHODS
Level II, lesser-quality therapeutic randomized controlled trial.
Camanho
Gilberto Luis
GL
Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil. gilbertocamanho@uol.com.br
Viegas
Alexandre de Christo
Ade C
Bitar
Alexandre Carneiro
AC
Demange
Marco Kawamura
MK
Hernandez
Arnaldo José
AJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D031222:Patellar Dislocation / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D017847:Patellar Ligament / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D026741:Physical Therapy Modalities; D011859:Radiography; D020127:Recovery of Function; D012008:Recurrence; D012092:Replantation; D053441:Suture Anchors; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult