The purpose of this study was to determine how musculoskeletal physiotherapists in acute National Health Service (NHS) hospitals manage patients following a first time patellar dislocation.
National survey study.
All NHS acute hospitals with an accident and emergency and/or an orthopaedic department were surveyed.
306 institutions were surveyed.
Each institution was sent a 14 question self-administered questionnaire pertaining to the assessment, treatment, evaluation and outcome of patients following a first time patellar dislocation. After 3 weeks, all non-respondents were sent a reminder letter. After a further 3 weeks, those who had not responded by this time were sent a final reminder and copy of the questionnaire.
The survey response rate was 59%. The respondents indicated that first-time patellar dislocation was not a common musculoskeletal disorder managed by NHS physiotherapists, constituting an average of 2% of caseloads. The results suggested that physiotherapists most commonly assess for reduced quadriceps or VMO capacity, gait, patellar tracking and glide, and knee effusion when examining patients following a first-time patellar dislocation. The most common treatments adopted are reassurance, behaviour modification followed by proprioceptive, knee mobility, quadriceps and specific VMO exercises.
Generic lower limb assessment and treatment strategies are widely used to manage this patient group. Given the previous paucity in this literature, further study is now recommended to assess the efficacy of these interventions to provide UK physiotherapists with an evidence-base to justify their management strategies.
A national survey of the physiotherapy management of patients following first-time patellar dislocation Toby O. Smith, Rachel Chester, Allan Clark, Simon T. Donell, Richard Stephenson
Physiotherapy - December 2011 (Vol. 97, Issue 4, Pages 327-338, DOI: 10.1016/j.physio.2011.01.003)