PMID- 37553954
OWN - NLM
STAT- MEDLINE
DCOM- 20231121
LR  - 20240109
IS  - 2042-6186 (Electronic)
IS  - 1066-9817 (Print)
IS  - 1066-9817 (Linking)
VI  - 31
IP  - 6
DP  - 2023 Dec
TI  - The influence of directional preference on lateral patellar dislocation: a case 
      report.
PG  - 474-481
LID - 10.1080/10669817.2023.2242203 [doi]
AB  - BACKGROUND: There is little consensus on the conservative management of lateral 
      patellar dislocations (LPD). Mechanical diagnosis and therapy (MDT) is an 
      established classification system in the spinal and extremity population. This 
      case report describes the use of MDT in the management and classification of a 
      patient with LPD. CASE DESCRIPTION: The patient was a 20-year-old female with a 
      3-month history of left knee pain precipitated by a lateral patellar dislocation. 
      The patient described pain and a feeling of instability with standing and walking 
      and limitations in work and recreational activities which involve lifting, 
      squatting, and running. Based on the patient's response to repeated end range 
      knee movements, the patient was found to have a directional preference (DP) for 
      knee extension and instruction in performance of knee extension DP exercises was 
      provided. OUTCOMES: The patient's knee examination and subsequent intervention 
      included her responses to repeated end range knee movements. Her knee pain was 
      abolished, and strength, function, and motion were fully restored in five visits. 
      A minimal clinically important difference (MCID) was achieved on the Lower 
      Extremity Functional Scale (LEFS). At discharge, the patient was able to 
      independently manage symptoms and perform all work and recreational activities at 
      a pre-injury level and these improvements were maintained at a 9-month follow-up. 
      DISCUSSION: There are various management strategies for lateral patellar 
      dislocation. This case demonstrated the use of classifying, subgrouping, and 
      treating a patient with lateral patellar dislocation using the principle of DP. 
      CONCLUSION: The patient's outcomes suggest that MDT may be used in the 
      nonoperative management of people with LPD who present with a DP.
FAU - Chang, B
AU  - Chang B
AD  - Rusk Rehabilitation, NYU Langone Health New York, New York, USA.
FAU - Schenk, R J
AU  - Schenk RJ
AD  - Doctor of Physical Therapy Program, Tufts University School of Medicine, Boston, 
      MA, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20230808
PL  - England
TA  - J Man Manip Ther
JT  - The Journal of manual & manipulative therapy
JID - 9433812
SB  - IM
MH  - Female
MH  - Humans
MH  - Young Adult
MH  - Knee
MH  - Knee Joint
MH  - Pain/complications
MH  - Patella/injuries
MH  - *Patellar Dislocation/etiology/surgery
PMC - PMC10642310
OTO - NOTNLM
OT  - Directional preference
OT  - derangement
OT  - knee pain
OT  - lateral patellar dislocations classification
OT  - mechanical diagnosis and therapy
COIS- No potential conflict of interest was reported by the authors.
EDAT- 2023/08/09 06:43
MHDA- 2023/11/13 06:42
PMCR- 2024/08/08
CRDT- 2023/08/09 02:33
PHST- 2024/08/08 00:00 [pmc-release]
PHST- 2023/11/13 06:42 [medline]
PHST- 2023/08/09 06:43 [pubmed]
PHST- 2023/08/09 02:33 [entrez]
AID - 2242203 [pii]
AID - 10.1080/10669817.2023.2242203 [doi]
PST - ppublish
SO  - J Man Manip Ther. 2023 Dec;31(6):474-481. doi: 10.1080/10669817.2023.2242203. 
      Epub 2023 Aug 8.