From the Research
Patella dislocation should be initially treated with the RICE protocol, followed by a gradual return to activity and physical therapy focusing on quadriceps strengthening exercises, with surgery considered for patients with anatomical abnormalities or recurrent dislocations, as supported by the most recent study 1. The initial treatment of patella dislocation involves the RICE protocol: Rest the knee, apply Ice for 15-20 minutes every 2-3 hours, use Compression with an elastic bandage, and Elevate the leg above heart level. Pain management typically includes NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (250-500mg twice daily). For severe pain, acetaminophen (500-1000mg every 6 hours) may be added. A knee immobilizer should be worn for 1-3 weeks, followed by a gradual return to activity. Physical therapy focusing on quadriceps strengthening exercises is crucial for recovery and prevention of recurrence. Some key points to consider in the treatment of patella dislocation include:
- The use of a prehospital patella reduction protocol, which has been shown to be successful in reducing pain and improving outcomes 2
- The importance of identifying risk factors for recurrent instability, such as young patient age, patella alta, trochlear dysplasia, and lateralization of the tibial tubercle 3
- The use of predictive scoring models to identify patients at high risk of recurrence 3
- The consideration of surgical treatment for patients with anatomical abnormalities or recurrent dislocations, with medial patellofemoral ligament reconstruction being an effective treatment to prevent recurrent dislocations and yield excellent outcomes 1
- The importance of long-term management, including maintaining quadriceps strength and using supportive bracing during high-risk activities. It is also important to note that the treatment of patella dislocation should be individualized based on the specific needs and risk factors of each patient, and that a comprehensive treatment plan should include a combination of conservative and surgical treatments as needed. The most recent study 1 provides evidence-based rehabilitation practice guidelines and expected outcomes for lateral patellar dislocation, and should be considered in the development of a treatment plan.