Development of the the rehabilitation interventions for people with an acute patellar dislocation in the PRePPeD (Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD) pilot randomized controlled trial

Journal article

Aims: To develop the rehabilitation interventions for people with an acute patellar dislocation in the Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD) pilot randomized controlled trial (RCT), and to describe how these interventions are delivered.

Methods: We developed the interventions drawing on a range of established intervention development approaches and frameworks. We selected intervention components after reviewing the existing evidence, clinical guidelines, UK NHS practice, and relevant scientific theory. We then created early versions of the interventions, and discussed these with clinical experts and patient and public partners. We finalized the interventions considering their feedback, findings from our preliminary study, and what would be acceptable and deliverable in the UK NHS.

Results: Upon randomization, all participants receive a workbook containing advice and initial exercises to implement before their first physiotherapy session. Self-managed rehabilitation then involves a single one-to-one session with a physiotherapist who provides advice, introduces a structured home exercise programme, and uses strategies to support exercise adherence. Participants then continue their recovery independently. Supervised rehabilitation involves four to six one-to-one physiotherapy sessions over a maximum of six months. Physiotherapists also provide advice, prescribe home exercise, and use exercise adherence strategies. Routine follow-up sessions enable physiotherapists to reassess participants and tailor the advice and exercises accordingly.

Conclusion: The interventions were developed and are currently being assessed in the PRePPeD pilot RCT. This will determine whether a full-scale RCT comparing these interventions is feasible. Results are anticipated in Summer 2025.

Authors: Forde, C; Costa, ML; Tutton, E; Cook, JA; Keene, DJ

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: British Editorial Society of Bone and Joint Surgery
• Journal: Bone & Joint Open
• Volume: 6
• Issue: 4
• Pages: 469 - 479
• Publication date: 2025-04-22
• Acceptance date: 2024-10-29
• DOI: 10.1302/2633-1462.64.bjo-2024-0174
• EISSN: 2633-1462
• Language: English
• Keywords: patella; patellofemoral dislocation; patellar dislocation; patellar instability; rehabilitation; physical therapy; exercise; acute patellar dislocations; patellar dislocations; physiotherapy; randomized controlled trial; physical therapists; supervised rehabilitation; exercise programmes; knee; muscle strength