title: A treatment algorithm for primary patellar dislocations.
abstract: BACKGROUND
  Primary patellar dislocation continues to be a common problem facing clinicians today. These injuries are associated with significant morbidity and a substantial recurrence rate. Myriad operative and nonoperative options have been described to treat these injuries, although the evidence-based literature is sparse.
  
  
  METHODS
  PubMed was searched from 1970-2010 to identify publications on patellar dislocations, including clinical presentation, natural history, radiographic workup, and treatment.
  
  
  RESULTS
  The initial workup of a patella dislocation includes a history, physical examination, and radiographs. If there is evidence of a displaced osteochondral fragment or hemarthrosis, then magnetic resonance imaging should be obtained. The treatment of first-time patella dislocators has been controversial, and no study has demonstrated a clear benefit to early operative intervention.
  
  
  CONCLUSIONS
  First-time patellar dislocations should be treated conservatively unless there is evidence of a displaced osteochondral fragment.
authors.affiliation: Department of Orthopaedics, Southern California Permanente Medical Group, San Diego Knee and Sports Medicine Research Fellowship, San Diego, California.
authors.forename: Neel P
authors.initials: NP
authors.lastname: Jain
authors.forename: Najeeb
authors.initials: N
authors.lastname: Khan
authors.forename: Donald C
authors.initials: DC
authors.lastname: Fithian