Paramedic Patella Reduction Reduces Hospital Transport and Dislocation Time

Acute patellar dislocation is a common orthopedic emergency frequently involving rupture of the medial patellofemoral ligament, the primary stabilizer against lateral displacement [1]. While conservative management is common, approximately 25% of patients experience recurrent instability, and 50% report persistent symptoms such as pain and functional limitations that diminish quality of life [2]. Surgical intervention may be indicated to improve outcomes, as data show significantly lower re-dislocation rates compared to conservative care (p = 0.023) and superior functional recovery on the Kujala score, a 100 point scale assessing patellofemoral function (89.83 versus 80.94; p = 0.017) [3]. The socioeconomic impact is also substantial, with orthopedic trauma resulting in a mean of 102.3 days absent from work and a 13% rate of employment loss at one year post-injury [4]. Traditional prehospital protocols focus on stabilization and analgesia, yet delays in definitive joint relocation may exacerbate joint morbidity, which refers to the permanent damage of articular structures and cartilage, and prolong patient distress [5]. This study evaluates whether shifting definitive relocation from the emergency department to the initial paramedic encounter improves clinical trajectories.