BACKGROUND: There is no consensus about the management of acute primary @entity8043 in young physically active adults. The objective of this study was to compare the clinical outcomes after treatment with and without initial stabilizing surgery for primary @entity8043 in young adults. METHODS: Forty young adults, thirty-seven @entity1 and three @entity1 with a median age of twenty years (range, nineteen to twenty-two years), who had an acute primary @entity8043 were randomly allocated to be treated with initial surgical stabilization (eighteen @entity1 , with each receiving one of two types of initial stabilizing procedures) or to be managed with an orthosis (twenty-two @entity1 , including four who had @entity4713 removed arthroscopically). After a median of seven years, thirty-eight @entity1 returned for a follow-up examination. Redislocations, subjective symptoms, and functional limitations were evaluated. Radiographs and magnetic resonance images were obtained at the time of randomization, and twenty-nine (76%) @entity1 underwent magnetic resonance imaging at the time of final follow-up. RESULTS: A @entity5631 as well as injuries of the medial retinaculum and the medial patellofemoral ligament were found on magnetic resonance imaging in all @entity1 at the time of randomization. During the follow-up period, six of the twenty-one nonoperatively treated @entity1 and none of the seventeen @entity1 treated with surgical stabilization had a redislocation (p = 0.02). Four nonoperatively treated @entity1 and two @entity1 treated with surgical stabilization reported painful @entity7194 . The median Kujala scores were 91 points for the surgically treated @entity1 and 90 points for the nonoperatively treated @entity1 . Thirteen @entity1 in the surgically treated group and fifteen in the nonoperatively treated group regained their former physical activity level. At the time of follow-up, a full-thickness patellofemoral articular cartilage lesion was detected on magnetic resonance imaging in eleven @entity1 ; the lesions were considered to be unrelated to the form of treatment. CONCLUSIONS: In a study of young, mostly male adults with primary @entity8043 , the rate of redislocation for those treated with surgical stabilization was significantly lower than the rate for those treated without surgical stabilization. However, no clear subjective benefits of initial stabilizing surgery were seen at the time of long-term follow-up.

Treatment with and without initial stabilizing surgery for primary XXXX . A prospective randomized study.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'men'] @entity4713 :: ('MESH:D010007', 'Disease') :: ['osteochondral fragments'] @entity7194 :: ('MESH:D007906', 'Disease') :: ['patellar subluxation'] @entity8043 :: ('MESH:D031222', 'Disease') :: ['traumatic patellar dislocation'] @entity5631 :: ('MESH:D006395', 'Disease') :: ['hemarthrosis']
@entity8043 :: (MESH:D031222,Disease) :: ['traumatic patellar dislocation']
