title: Non-surgical treatment for acute patellar dislocation with special emphasis on the MPFL injury patterns.
abstract: OBJECTIVE
  The objective of present study was to propose a new classification for acute MPFL injury, which can help choose optimal treatment method for certain injury type.
  
  
  METHODS
  Eighty-five patients with acute patellar dislocation treated non-surgically were retrospectively reviewed. They were assigned into two groups according to the newly introduced classification scheme, which classified MPFL injury into three types: injury in overlap region, injury in non-overlap region and combined injury of both regions. For study purpose, patients with combined injury were not included. Of 85 patients, 33 were in the overlap-region group (Group 1) and 52 in the non-overlap-region group (Group 2). Clinical patellar instability rate and patellofemoral score were measured and recorded at 2-year follow-up.
  
  
  RESULTS
  The patellar instability rate was 15.2 % in Group 1 and 38.5 % in Group 2, with statistically significant difference between the two groups (P = 0.022). The mean visual analogue scale for Group 1 and Group 2 was 15.6 points and 28.3 points, respectively (P = 0.026). The mean Kujala score was 91.1 points and 82.6 points (P = 0.009), with a good or excellent subjective result recorded for 27 of 33 patients (81.8 %) in Group 1 compared with 30 of 52 patients (57.7 %) in Group 2 (P = 0.021).
  
  
  CONCLUSIONS
  Non-surgical treatment achieves better clinical outcomes with respect to a lower patellar instability rate and better subjective function for the overlap-region injury of MPFL than for the non-overlap-region injury, and can be considered as treatment of choice for overlap-region injury of MPFL. The optimal choice for the non-overlap-region injury still requires further researches.
  
  
  METHODS
  Therapeutic, Level IV.
authors.affiliation: Department of Orthopaedic Surgery, Shijiazhuang No.1 Hospital, Shijiazhuang, Hebei, 050011, China.
authors.forename: Hui Jun
authors.initials: HJ
authors.lastname: Kang
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.forename: Bai Cheng
authors.initials: BC
authors.lastname: Chen
authors.forename: Ying Ze
authors.initials: YZ
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007718:Knee Injuries / Q000145:classification* / Q000175:diagnosis / Q000628:therapy*; D008023:Ligaments, Articular / Q000293:injuries*; D008297:Male; D031222:Patellar Dislocation / Q000145:classification* / Q000175:diagnosis / Q000628:therapy*; D057071:Patellofemoral Joint / Q000293:injuries*; D012189:Retrospective Studies; D055815:Young Adult