Abstract
Patellar dislocations occur at a much higher rate in military than civilian populations.
Past population-level studies have shown that surgical management is as good as or
superior to conservative care and may reduce future reoccurrences. Although in acute
cases and in civilian clinics, patellar dislocations are usually managed first in
an emergent care setting, previous work suggests this can lead to increased costs.
This study compared differences in downstream care type and intensity of services
based on whether initial care occurred in emergent or non-emergent care settings.
In our sample of 1,523 Military Health System (MHS) beneficiaries with patellar dislocation
and 2-year follow-up, we found non-significant differences in costs, intensity of
services, and rates of surgical repair regardless of whether the patient was initially
seen in an emergent versus non-emergent care setting. Although we found significant
increases in the use of imaging, patellar dislocation-related medical visits, and
frequency of closed treatment approaches in emergent care settings, these values were
very small and likely not clinically significant. These findings, which included all
the patellar dislocations reported across the entire MHS in a 24-month period, suggest
that neither emergent nor non-emergent care settings are likely to influence the long-term
care received by the individual.
Keywords
patellofemoral pain syndrome - physical therapy - dislocation - military medicine
