36 patients, 16 years of age or younger, with acute primary patellar dislocation, were allocated to operative management or nonoperative management. The purpose of this study was to compare subjective clinical outcome measures and rate of recurrent dislocation between groups over a 6 year follow-up period. Concerning subjective clinical outcome measures, there were no significant between-group differences in patient-reported function or satisfaction. The recurrent dislocation rate was significantly lower in the operatively managed group compared to the nonoperatively managed group