title: [Patella dislocation: an algorithm for diagnostic and treatment considering the rotation].
abstract: BACKGROUND
  Patella dislocation and re-dislocation are common diseases. Although patella dislocation is frequent, it always poses a challenge concerning diagnostics and therapy. Mixed forms of pathological disorder in the patellofemoral joint make the analysis of the malalignment and the choice of the correct treatment more difficult.
  
  
  METHODS
  By reviewing the available literature of the last few years and taking into account considerations concerning the malalignment, an overview of the necessary diagnostics can be given. Radiographs and MRI are essential parts of the diagnostics after a traumatic patella dislocation. After re-dislocation, more extensive diagnostics are required to determine all pathological aspects of the malalignment. In this situation, a CT scan for measuring the torsion of the femur and the tibia as well as the TT-TG distance (tibial tubercle - trochlea groove), and the full weight-bearing long leg standing radiograph are part of the fundamental diagnostics.
  
  
  RESULTS
  The results that are presented in the literature provide some indications for a successful treatment. In consideration of the thorough analysis of the malalignment, the torsional correction of the femur and/or the tibia gains a new importance in the patellofemoral joint. The presented algorithm for diagnostics and treatment should make the decision for the best treatment easier.
  
  
  CONCLUSIONS
  The proposed algorithm for diagnostics and treatment is only partially founded on evidence-based results. Moreover, it takes into consideration reflections concerning the biomechanics of the patellofemoral joint and the realignment of this joint.
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen.
authors.forename: A
authors.initials: A
authors.lastname: Ateschrang
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen.
authors.forename: T
authors.initials: T
authors.lastname: Freude
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen.
authors.forename: L
authors.initials: L
authors.lastname: Grünwald
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen.
authors.forename: A
authors.initials: A
authors.lastname: Schäffler
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen.
authors.forename: U
authors.initials: U
authors.lastname: Stöckle
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen.
authors.forename: S
authors.initials: S
authors.lastname: Schröter
mesh_terms: D000465:Algorithms; D019317:Evidence-Based Medicine; D006801:Humans; D031222:Patellar Dislocation / Q000175:diagnosis* / Q000628:therapy*; D018802:Patient-Centered Care / Q000379:methods*; D010808:Physical Examination / Q000379:methods*; D016059:Range of Motion, Articular; D014057:Tomography, X-Ray Computed / Q000379:methods*