Back on track, but still benched: Long-term impact of patellar dislocation on sport and function - A retrospective cohort study.

Abstract

To assess the long-term clinical outcomes following patellar dislocation, including patients with primary and recurrent dislocations and those treated surgically. A retrospective cohort study of patients with patellar dislocation between January 2019 and December 2022. Participants completed a questionnaire >6 months after their most recent dislocation or >1 year following patellar stabilization surgery. The primary outcome was the Kujala score. Secondary outcomes included the Tegner Activity Scale, Knee Self-Efficacy Scale (K-SES), Patient Acceptable Symptom State (PASS), and the Sporting Activity Questionnaire (SAQ). Comparisons were made between primary dislocations, recurrent dislocations, and those who underwent surgery. 228 participants were included: 66 with primary dislocation, 88 with recurrent dislocations, and 74 who had undergone surgery. The median Kujala score was 89 (78-96) for primary, 82 (72-92) for recurrent, and 78 (65-89) for the surgical group (p < 0.001). The SAQ showed a decline in high-impact sport participation and an increase in no sport participation from pre-to post-injury. These changes were statistically significant in the recurrent group (p < 0.001) and the surgery group (p < 0.001), but not in the primary group (p = 0.143). According to PASS, 49 % of participants reported dissatisfaction with their current knee function. Patellar dislocations may cause long-term physical limitations and reduced sports participation, with about half of patients dissatisfied with knee function after 2-3 years. Surgery does not appear sufficient to restore patients to full physical function.