Age, anatomic factors may identify patients at risk for patella redislocation
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SAN FRANCISCO — Patients who present with a first-time patella dislocation with no cartilage injury should be assessed for risk factors for redislocation and considered for rehabilitation, according to a presenter here.
In her presentation at the Arthroscopy Association of North America Annual Meeting, Sabrina M. Strickland, MD, noted previously published research has shown age younger than 25 years, patella alta and trochlea dysplasia were linked with a 5-year risk of recurrence of patella dislocation at 70%. In addition to younger age, research has also shown patients who are skeletally immature had a high risk of lateral patellar redislocation, according to Strickland.
“So not just under 25 [years], but these patients were still growing, had a sulcus angle over 154°, trochlear dysplasia and patella alta,” Strickland said.
However, Strickland noted surgeons may be able to predict a patient’s risk of redislocation by plugging variables, including age, patellar height, tibial tuberosity-trochlear groove distance and femoral anteversion, into an algorithm. If patients have no cartilage injury but a high risk of dislocation, she said surgeons should consider being more aggressive surgically in their treatment of these patients.
“When you see these first-time dislocators with no cartilage injury, you can assess the risk factors [and] talk to the family, and I think a lot of these patients understand when you give them these odds,” Strickland said. “Potentially, you should look at some of these patients and operation on them rather than wait until the second time.”
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Strickland SM. Current management of a first-time patella dislocation: Risk stratification. Presented at: Arthroscopy Association of North America Annual Meeting. May 19-21, 2022; San Francisco.
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