Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of recurrent right patellar dislocation. Reports multiple episodes of the patella shifting laterally, often associated with a popping sensation and subsequent pain. Current episode triggered by [mechanism of injury/activity]. Patient reports persistent instability, apprehension, and occasional locking/giving way. No history of direct trauma in this instance.
Clinical Examination Findings
Right knee examination reveals positive patellar apprehension test. Lateral patellar tilt and glide are increased. Q-angle is [measured value]. No significant effusion noted. Range of motion is [degrees] with pain at terminal extension. Neurovascular status is intact distally. Ligamentous stability (ACL/PCL/MCL/LCL) is stable. No joint line tenderness.
Treatment Protocol
Initiate physical therapy focusing on VMO strengthening, core stability, and proprioceptive training. Prescribe patellar stabilizing brace for activity. Consider referral for MRI to evaluate MPFL integrity and trochlear morphology. Discuss surgical options (MPFL reconstruction/distal realignment) if conservative management fails.