The traumatic factor plays a prominent rôle in this condition. Two types of cases are noted: (1) the. Academic Surgeons. Upstate Orthopedics, LLP – Upstate Medical University Department of Orthopedic Surgery in Syracuse, NY is seeking a BC/BE Surgeons in. Habitual dislocation of patella. 1. Case Presentation Habitual Dislocation of Patella Dr Sushil Sharma First Year MS Orthopaedic Resident; 2.
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The major intra-operative finding was contracture of the lateral patellar retinaculum with fibrotic bands in the superolateral aspect of patella. There was no associated leg dysplasia. The preoperative Kujala et al. All patellae were small, hypoplastic and hypermobile but no patient had patella alta.
Reconstruction of medial patellofemoral ligament for chronic patellar instability. There was a or surgical scar over middle and lower third lateral aspect of the left thigh. An anatomic radiographic study.
Habitual dislocation of patella: A review
Factors of patellar instability: Two holes were drilled into the patellar bone by a medial parapatellar approach. Habitual dislocation of patella, lateral release, medial patello-femoral ligament, reconstruction, quadricepsplasty, tibial tuberosity transfer. At re-exploration in each case, recurrent contracture was apparent in the line of the original vastus lateralis, and there had been incomplete elongation of rectus femoris or vastus lateralis.
They also recommended that various soft tissue procedures are necessary in combination for the correction of habitual dislocation of patella in adults with high grade patella-femoral chondromalacia.
Benoit published their series of 12 cases of habitual dislocation of patella with patella alta.
The rest of the clinical examination, in particular the neurological, muscular, and tendon results were normal. The patellar height was restored to normal by distal advancement of patellar tendon.
In our case, we have done medial patello-femoral ligament reconstruction using semi-tendinosus tendon.
Insall J, Salvati E. Family habityal of dislocation was positive in a few patients and other abnormalities were noticed in some cases. Received Aug 18; Accepted Sep The patella has been stabilized with extensive proximal release and vastus medialis advancement. Predisposing factors include ligamentous laxity, contracture of the lateral patellar soft tissues, patella alta, quadriceps contractures, hypoplasia of the lateral femoral condyle and genu valgum bony factors.
Habitual dislocation of patella: A review
Therefore, there was no indication for recentering the patella or lowering the tibial tubercle by osteotomy. However it may present in childhood with dysfunction and instability. Support Center Support Center.
On the femoral side, there was no crossing sign or spurs, and the depth of the trochlear groove was normal. Many different surgical techniques have been described in the literature for the treatment of habitual dislocation of patella. At birth they may present with a stiff extended knee or congenital recurvatum or congenital dislocation. J Bone Joint Surg. A year-old man, construction worker, presented a habitual patellofemoral dislocation which was caused by direct trauma to the knee as a child.
Postoperative radiographs anteroposterior a and lateral views b of left knee showing tibial tuberosity transfer fixed with screws and 2. Combined proximal and distal realignment procedures to treat the habitual dislocation of the patella in adults. These techniques are all designed to relocate the patella and regain alignment of the extensor mechanism.
There were no scars on the knee. Author information Copyright and License information Disclaimer.
Introduction The origin of recurrent patellar instability is usually posttraumatic. If it was not possible to fully flex the knee at this stage, rectus femoris with or without vastus intermedius was lengthened to achieve reduction in full flexion of the knee. The medial border of the patella was calcified.
If patella still dislocates after full flexion is achieved, distal oatella is added. Postoperative X-rays of the knee: Two-staged procedure was planned, first with patellar realignment and later with definitive total knee arthroplasty. He also noted that quadriceps fibrosis involving the rectus femoris and vastus intermedius alone would result in an elevated and hypoplastic patella.
Comparative weight-bearing X-ray lateral view: Footnotes Source of Support: Patella reduced after release of Iliotibial tract and vastus lateralis. Pathophysiology Various pathological factors have been described in the pathogenesis of habitual dislocation of patella.
Case Reports in Orthopedics
They performed arthroscopy in all cases and found that chondromalacia of the patella grade III to grade IV was present in all cases. View at Google Scholar T. Treatment of chronic patellar dislocation with a modified Elmslie-Trillat procedure.
In a study of 14 patients Drez et al. Total knee arthroplasty in bilateral congenital dislocation of the patella: As already mentioned by Fithian et al.
The etiology of quadriceps contracture in children. The surgery included lateral release, advancement of medial retinaculum, and the anteromedial tibial tubercle transfer.
Genu valgum, defects of the patella and femoral condyles were also present in a few cases of habitual dislocations. Williams reported clinical presentations and pathophysiology in patients with quadriceps contractures.