How is an acute patellar dislocation typically managed acutely?

How is an acute patellar dislocation typically managed acutely?

• A. Observation without intervention
• B. Immediate surgical fixation
• C. Long-term immobilization
• D. Gentle closed reduction, immobilization, and progressive rehabilitation; assess MPFL injury if recurrent

Answer: (D)

The key idea is that an acute patellar dislocation is managed by promptly returning the kneecap to its normal position and then guiding the knee back to function. The best approach is a gentle closed reduction to realign the patella, usually done with analgesia or light sedation. After reduction, the knee is immobilized for a short period to allow soft tissues around the patella to heal, followed by a structured rehabilitation program that restores range of motion and strengthens the quadriceps and hip stabilizers to improve tracking. Importantly, an MPFL injury is commonly present, and assessing it is crucial because if instability recurs, addressing the MPFL (often with reconstruction) may be needed. Observing without intervention would leave the patella out of place and the knee unstable and painful. Immediate surgical fixation isn’t typical for a first-time dislocation unless there’s an accompanying fracture. Prolonged immobilization is discouraged due to stiffness and weakness, so short immobilization with progressive rehab is preferred.

The key idea is that an acute patellar dislocation is managed by promptly returning the kneecap to its normal position and then guiding the knee back to function. The best approach is a gentle closed reduction to realign the patella, usually done with analgesia or light sedation. After reduction, the knee is immobilized for a short period to allow soft tissues around the patella to heal, followed by a structured rehabilitation program that restores range of motion and strengthens the quadriceps and hip stabilizers to improve tracking. Importantly, an MPFL injury is commonly present, and assessing it is crucial because if instability recurs, addressing the MPFL (often with reconstruction) may be needed.

Observing without intervention would leave the patella out of place and the knee unstable and painful. Immediate surgical fixation isn’t typical for a first-time dislocation unless there’s an accompanying fracture. Prolonged immobilization is discouraged due to stiffness and weakness, so short immobilization with progressive rehab is preferred.