Physiotherapy
Volume 96, Issue 4 , Pages 269-281, December 2010

Clinical outcomes of rehabilitation for patients following lateral patellar dislocation: a systematic review

  • Toby O. Smith

      Affiliations

    • Institute of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, UK
    • Faculty of Health, University of East Anglia, Norwich, UK
    • Corresponding Author InformationCorresponding author at: Institute of Orthopaedics, Norfolk & Norwich University Hospital, Colney Lane, Norwich NR2 7UY, UK. Tel.: +44 01603 286990; fax: +44 01603 287369.
    • ,
  • Leigh Davies

      Affiliations

    • Physiotherapy Department, Norfolk and Norwich University Hospital, Norwich, UK
    • ,
  • Rachel Chester

      Affiliations

    • Physiotherapy Department, Norfolk and Norwich University Hospital, Norwich, UK
    • Faculty of Health, University of East Anglia, Norwich, UK
    • ,
  • Allan Clark

      Affiliations

    • Faculty of Health, University of East Anglia, Norwich, UK
    • ,
  • Simon T. Donell

      Affiliations

    • Faculty of Health, University of East Anglia, Norwich, UK

published online 26 April 2010.

Abstract 

Objectives

Little has been published about which physiotherapy interventions are used to treat patients with instability of the patella. The purpose of this study was to review the literature systematically to determine the clinical outcomes of rehabilitation for patients following a lateral patellar dislocation.

Data sources

AMED, CINHAL, Cochrane Library, EMBASE, MEDLINE, PEDro and Scopus database searches were performed from their inception to August 2009. A search of unpublished and grey literature databases was undertaken, in addition to contacting all authors of included publications.

Review methods

All publications presenting the outcomes of patients following a conservatively managed lateral patellar dislocation were included. All eligible articles were appraised critically using the Critical Appraisal Skills Programme appraisal tool. Data on interventions, cohort characteristics, outcome measures and results were extracted. A narrative research synthesis method approach was adopted.

Results

In total, 29 publications were eligible for inclusion in this review. Although a proportion of patients experienced recurrent instability and dislocation episodes after rehabilitation, a large proportion of patients reported acceptable outcomes following physiotherapy. No randomised controlled clinical trials were identified assessing different physiotherapy interventions. The evidence base included a number of under-powered studies which poorly described the specific physiotherapy interventions prescribed.

Conclusions

Further, well-designed randomised controlled trials assessing different conservative management strategies with specific patient groups, to provide pre-intervention as well as follow-up data, are required to determine the optimal clinical outcomes of physiotherapy for patients following a lateral patellar dislocation.

Keywords: Patellar dislocation, Physiotherapy, Rehabilitation, Conservative treatment, Systematic review

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PII: S0031-9406(10)00034-9

doi:10.1016/j.physio.2010.02.006

Physiotherapy
Volume 96, Issue 4 , Pages 269-281, December 2010

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