Patellar dislocation : an algorithm for management within primary care

Abstract

BACKGROUND: Patellar dislocation is a common condition which may present to primary care. The literature available on this condition discusses evaluation, assessment of risk factors for recurrence, and non-surgical versus surgical management. Literature detailing its management specifically within primary care is lacking.

OBJECTIVES: The purpose of this review paper is to review and discuss the steps in evaluation and management of this condition and formulate an algorithm summary particular to a primary care setting.

METHOD: A database search was carried out using specific keywords and terms. The authors’ initial selection of 12 articles were subsequently reduced to 8 after review of their relevance to a primary care setting, and these were subjected to in-depth analysis. The information gathered was detailed and discussed, and a subsequent algorithm was formulated.

RESULTS: Patellar dislocation is a common injury, which may have long-lasting consequences to knee stability if not initially managed appropriately. There is inconclusive evidence to favour a surgical versus non-surgical approach. Evaluation of an individual’s risk factors and whether referral to secondary care is required are crucial steps in management of this condition.

CONCLUSION: Primary care physicians may play a key role in appropriate management of an individual’s first presentation of patellar dislocation, as well as assessment on the need for secondary care referral. The algorithm proposed by the authors may assist primary care physicians in improving management of patellar dislocation within a primary care context.