Management of first-time patellar dislocation: The ESSKA 2024 formal consensus-Part 2.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Peter Balcarek reports consulting for Arthrex. Philippe Beaufils serves as the ESSKA Consensus Projects Advisor. Florian Dirisamer reports consulting for Arthrex and receives royalties from Arthrex Inc. Rene El Attal reports consulting for Arthrex, DepuySynthes and ZimmerBiomet. Geert Pagenstert reports consulting for DepuySynthes and Stryker. Joan Minguell reports consulting for Arthrex and Smith&Nephew. Petri Sillanpaa reports consulting for Inion LTD. Ramazan Akmeşe reports consulting for Smith&Nephew, and Jacek Walawski reports consulting for Arthrex, Moximed and Smith&Nephew. The remaining authors declare no conflicts of interest. 4. Curr Rev Musculoskelet Med. 2018 Jun;11(2):182-187. doi: 10.1007/s12178-018-9473-4. MPFL in First-Time Dislocators. Shubin Stein BE(1), Gruber S(2), Brady JM(3). Author information: (1)Hospital for Special Surgery, New York City, NY, USA. (2)Hospital for Special Surgery, New York City, NY, USA. grubers@hss.edu. (3)Oregon Health and Science University, Portland, OR, USA. PURPOSE OF REVIEW: Historically, the standard of care for patients with an acute patella dislocation has been non-operative with the exception being those with a loose body or osteochondral fracture requiring fixation or removal. RECENT FINDINGS: Recent literature has brought into question this standard of care approach and defined a higher risk subset of first-time dislocators who may benefit from early operative treatment. In addition, these studies suggest that operative treatment not only reduces the risk of recurrence but may improve outcomes overall and specifically in the pediatric population. Though the "high risk" population of first-time dislocators has been more clearly defined, how we treat them remains controversial. We continue to need more evidence-based guidelines to help us manage who we should be fixing and how we should be fixing them. We currently have several multi-center studies in progress, including one specifically looking at the question of medial patellofemoral ligament reconstruction in first-time pediatric and adolescent dislocators. DOI: 10.1007/s12178-018-9473-4 PMCID: PMC5970108