Do teen-age patients with a dislocated knee cap do better with or without a brace?

This study will look at two different ways to treat teen-age patients who have had a dislocation of their knee cap. Both groups will receive the physical therapy treatment for knee cap dislocation but one group will first be in a brace for a week and the other group will start moving in therapy right away.

Inclusion Criteria:

• Male and female adolescents between 11-17 years
• Medical diagnosis of 1st time lateral patellar instability episode (dislocation or subluxation)
• Subjective history of knee shifting, instability, popping out, knee effusion
• Apprehension test is positive and has medial patellar tenderness
• Referred to the Texas Children's Hospital (TCH) outpatient sports medicine clinic from an emergency room facility, urgent care or pediatrician within 10 days of the injury.
• Free of co-morbidities that would prevent or limit rehabilitation including cardiac, pulmonary, psychiatric (except Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), orthopedic, neurological
• Must be able to follow directions and participate in rehabilitation protocol for the 3-month study period.

Exclusion Criteria:

• Imaging or clinical findings suggest surgical intervention is needed i.e. fracture, osteochondral defect, Lachman or other positive knee ligament special tests.