Clinical outcomes of rehabilitation for patients following lateral patellar dislocation: a systematic review.
OBJECTIVE
Little has been published about which physiotherapy interventions are used to treat patients with instability of the patella. The purpose of this study was to review the literature systematically to determine the clinical outcomes of rehabilitation for patients following a lateral patellar dislocation.


METHODS
AMED, CINHAL, Cochrane Library, EMBASE, MEDLINE, PEDro and Scopus database searches were performed from their inception to August 2009. A search of unpublished and grey literature databases was undertaken, in addition to contacting all authors of included publications.


METHODS
All publications presenting the outcomes of patients following a conservatively managed lateral patellar dislocation were included. All eligible articles were appraised critically using the Critical Appraisal Skills Programme appraisal tool. Data on interventions, cohort characteristics, outcome measures and results were extracted. A narrative research synthesis method approach was adopted.


RESULTS
In total, 29 publications were eligible for inclusion in this review. Although a proportion of patients experienced recurrent instability and dislocation episodes after rehabilitation, a large proportion of patients reported acceptable outcomes following physiotherapy. No randomised controlled clinical trials were identified assessing different physiotherapy interventions. The evidence base included a number of under-powered studies which poorly described the specific physiotherapy interventions prescribed.


CONCLUSIONS
Further, well-designed randomised controlled trials assessing different conservative management strategies with specific patient groups, to provide pre-intervention as well as follow-up data, are required to determine the optimal clinical outcomes of physiotherapy for patients following a lateral patellar dislocation.
Institute of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, UK. toby.smith@nnuh.nhs.uk
Toby O
TO
Smith
Leigh
L
Davies
Rachel
R
Chester
Allan
A
Clark
Simon T
ST
Donell
D006801:Humans; D031222:Patellar Dislocation / Q000534:rehabilitation*; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities