Reduction of Patellar Dislocation Technique

Updated: Apr 13, 2017
  • Author: Moira Davenport, MD; Chief Editor: Erik D Schraga, MD  more...
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Technique

Approach Considerations

Obtain prereduction and postreduction radiographs to rule out any osteochondral fractures, if such lesions are suspected on the basis of mechanism of injury or findings from physical examination.

Computed tomography (CT) can detect small bony fragments that result from patellar dislocation. These fragments often are not seen on standard radiographs. CT should be considered in first-time dislocation patients and in dislocations that result from significant forces. [9]

The literature reports controversy regarding which patients should undergo operative repair of primary dislocations. Most patients do well with a short course of immobilization followed by physical therapy. [10, 11]

Medial patellofemoral ligament injury typically results from patellar dislocation [12] ; thus, follow-up with an orthopedic surgeon is recommended for all patients with patellar dislocations. [13, 14, 15, 16, 17]

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Patellar Reduction

Stand on the lateral side of the leg on which the patellar reduction is to be done. (See the video below.) Slightly flex the injured leg at the hip to decrease tension on the quadriceps muscles. Extend the knee while applying gentle anteromedially directed force on the lateral patellar edge to lift the patella over the femoral condyle. For a medial dislocation, use the same technique, but stand medial to the dislocation and apply an anterolateral force.

Conducting patellar reduction.

When reduction is complete, apply a knee immobilizer so that the knee is in full extension.

Arrange a follow-up appointment for the patient with an orthopedic surgeon. Some patients with complete dislocation may require surgery to prevent recurrence.

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Complications

Osteochondral fractures are a very uncommon complication of reduction of a patellar dislocation. Related complications of the dislocation itself may include recurrent dislocations, degenerative arthritis, or osteochondral fractures.

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