2015 ISAKOS Biennial Congress ePoster #1908

Comparison of Immobilisation Methods In Paediatric First-Time Patella Dislocators

Kai Yet Lam, MBBS, MRCS, MMed(Orth), FRCS, Singapore SINGAPORE
Arjandas Mahadev, MBBS, MMed Orth(S'pore), FRCSEd, Singapore SINGAPORE

KK Women's and Children's Hospital, Singapore, Singapore, SINGAPORE

FDA Status Not Applicable

Summary: A review of clinical outcomes following the use of different forms of immobilisation in first-time patella dislocations.

Rate:

Abstract:

Background

First-time patella dislocations (FTPD) are generally treated non-operatively. However, the ideal form of conservative management and immobilization remains unknown. We compare the outcomes of different immobilization methods.

MATERIALS & METHODS
Paediatric-age patients that met our inclusion criteria, and presenting with a first episode of patella dislocation to our hospital from 2006 to 2013 were enrolled. Different immobilization methods included brace, backslab or cylinder cast. A retrospective review was performed to compare bracing against other immobilization methods, using outcome measures like redislocation rates, progression to surgery, range-of-motion, pain and weight-bearing status.

Results

142 patients (with 147 affected knees) with minimum one-year follow-up were included in the study. Bracing was found to be superior to other immobilization methods in preventing repeat dislocations, and need for subsequent surgery. At 6 weeks, cylinder casting had the lowest incidence of pain, and there was no difference with regards to range-of-motion or weight-bearing status.

Conclusion

Our study shows that immobilization in a brace, with a progressive rehabilitation protocol reduces the redislocation and surgery rates when compared with other immobilization methods. This study is also unique in that it specifically addresses non-operative management of FTPDs in a paediatric-age population group.