Plaster, splint, brace, tape or functional mobilization after first-time patellar dislocation: what's the evidence?

With an incidence of 5.8 per 100,000 per year, patellar dislocations are commonly seen in the emergency department. Surprisingly, there are only a few studies available that focus on the results of the different non-surgical treatment options after first-time patellar dislocation. The aim of this review is to provide an overview of the most recent and relevant studies on the rationales and results of the non-surgical treatment for first-time patellar dislocation. Patellar instability mainly affects young and active patients, with a peak incidence of 29 per 100000 per year in adolescents. The medial patellofemoral ligament, a main passive restraint for lateral translation of the patella, is torn in lateral patellofemoral dislocations. Treatment of first-time patellar dislocation can be either conservative or surgical. There are two options in conservative management of first-time patellar dislocation: immobilization using a cylinder cast or removable splint, or, second, functional mobilization after applying a brace or patellar tape. The current available literature of conservative treatment after a first-time patellar dislocation is little and of low quality of evidence. Conclusions should be drawn with care, new research focussing on non-surgical treatment is therefore strongly needed.