Immobilization Regime Following Lateral Patellar Dislocation: A Systematic Review and Meta-Analysis of the Current Evidence Base.

Abstract

Historically, patients following patellar dislocation have been immobilized in a cylinder plaster of Paris cast for around 6 weeks. However, there remains controversy over whether immobilization should be advocated following this injury. There also remains debate over the methods and duration for which patients are immobilized. A systematic review was undertaken to assess these questions. The electronic databases MEDLINE, EMBASE, CINAHL, and AMED, in addition to a review of unpublished material, was undertaken. All of the included papers were appraised using the CASP appraisal tool. Two studies were eligible, assessing the outcomes of 177 lateral patellar dislocations. The results suggested that there is no significant difference in clinical outcomes when using a cylinder cast or posterior splint in full extension compared to an elastic bandage. No studies were identified specifically assessing the clinical outcomes of patients immobilized compared to those not immobilized, or assessing different durations of immobilization. The present evidence base is insufficient in both size and methodological quality to justify the use of immobilization for patients following a lateral patellar dislocation.