Surgical medial patellofemoral ligament reconstruction versus non-surgical treatment of acute primary patellar dislocation: a prospective controlled trial

The acute primary (first-time) lateral patellar dislocation is associated with a high rate of functional disability. There is no consensus as to the choice of surgical or non-surgical treatment for these patients. The aim of this study is to compare the clinical results between the surgical (reconstruction of the medial patellofemoral ligament [MPFL]) and non-surgical treatments for acute primary patellar dislocations. Sixty-nine skeletally mature patients (69 knees) were included in this prospective non-randomized controlled trial. At least one predisposing factor for patellar dislocation (including patella alta, high lateral patellar tilt, trochlear dysplasia, and increased TT-TG distance) was identified in the included patients. Thirty patients were treated surgically with MPFL reconstruction, and the other 39 patients were treated non-surgically. The main outcome variable was patellar redislocation within a two year follow-up period. The Kujala questionnaire was applied for analyzing the pain and the quality of life. The additional surgeries due to patellofemoral problems were also recorded. Patellar redislocation occurred in eight patients in the non-surgical group, while no redislocation occurred in the surgical group (P