title: Six-year outcome after non-surgical versus surgical treatment of acute primary patellar dislocation in adolescents: a prospective randomized trial.
abstract: OBJECTIVE
  There is only one prospective randomized trial on acute primary patellar dislocation in adolescents comparing the long-term outcome after conservative versus operative procedures. Therefore, the long-term outcome, patellar redislocation rate, and functional outcome after conservative versus operative procedures were investigated in a prospective randomized study.
  
  
  METHODS
  Initially, 36 patients with acute primary patellar dislocation were prospectively randomized to conservative (n = 20) versus operative procedures (n = 16) and 30 of them (83%), 15/20 with conservative and 15/16 with operative procedures, were reached for a follow-up interview 6 years after primary procedure.
  
  
  RESULTS
  Baseline and clinical parameters were similar in the two groups. The prevalence of patellar redislocation rate at 3 and 6 years after primary procedure was higher in the conservative group (7/20, 35%, 3 years and 11/15, 73%, 6 years) versus in the operative group (0/16, 0%, 3 years and 5/15, 33%, 6 years) (p = 0.02). The knee function was slightly better 6 years after primary treatment in the operative group than in the conservative group. Most patients in both groups had excellent or good knee function at 6-year follow-up, but four patients (4/15, 27%) in conservative group and two patients (2/15, 13%) in operative group had poor knee function at 6-year follow-up. Four patients in conservative group (4/15, 27%) and two patients in the operative group (2/15, 13%) were unsatisfied with the procedure at 6-year follow-up.
  
  
  CONCLUSIONS
  In conclusion, the results suggest that both conservative and operative procedures are feasible options for treatment of acute primary patellar dislocation in adolescents. A new finding with clinical relevance in the present work is a significantly higher redislocation rate in conservative group compared to operative group after 6-year follow-up in acute primary patellar dislocation in adolescents.
  
  
  METHODS
  II.
authors.affiliation: Department of Surgery, South Carelia Hospital, Lappeenranta, Finland.
authors.forename: Gideon
authors.initials: G
authors.lastname: Regalado
authors.affiliation: School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Lintula
authors.affiliation: School of Medicine, University of Eastern Finland, Kuopio, Finland.|Department of Anestesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Kokki
authors.affiliation: School of Medicine, University of Eastern Finland, Kuopio, Finland.|Department of Orthopedics, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Kröger
authors.affiliation: School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Urho
authors.initials: U
authors.lastname: Väätäinen
authors.affiliation: School of Medicine, University of Eastern Finland, Kuopio, Finland. matti.eskelinen@kuh.fi.|Department of Surgery, Kuopio University Hospital (KYS), P.O. Box 100, 70029, Kuopio, Finland. matti.eskelinen@kuh.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Eskelinen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D031222:Patellar Dislocation / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D016896:Treatment Outcome
keywords: Adolescents; Patellar dislocation; Randomized trial; Redislocation; Treatment outcome