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 – surgical technique. Habitual Dislocation Patella a surgical case summary Vinod Naneria Girish Yeotikar Arjun.
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Discussion The causes of habitual patellar dislocation include contracture and fibrosis of the quadriceps femoris, vastus lateralis, and lateral retinaculum, abnormal iliotibial band attachment, repeated intramuscular injections into dialocation thigh, patella alta due to the abnormal position of an elongated patellar tendon, systemic ligament laxity, dysplastic lateral femoral condyle, and genu valgum 2 – 4.
Therefore, a reconstruction using a medial patellofemoral ligament allograft was not considered necessary and the reduction was maintained at the follow-up examination. Habitual or recurrent dislocation of the patella is common in children unlike adults.
Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children. Comparative weight-bearing X-ray lateral view: Traditionally, habitual dislocation has been treated in the same way as recurrent dislocation dislocatiom for the need for lengthening of the quadriceps tendon.
We chose to assess treatment using functional scores. The first line therapeutic strategy was surgical. Published by Elsevier B. Proximal realignment includes lateral release, reconstruction of the MPFL and quadriceps plasty. He said that habituall tuberosity transplant might be useful in adults, but in children it could causes genu recurvatum from premature closure of the anterior part of the epiphysis and distal migration of the tibial tubercle and traction spur.
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.
Habitual dislocation of patella: A review
Appropriate surgical treatment methods for habitual dislocation of the patella with genu valgum still remain controversial.
Lengthening of the rectus femoris tendon was also required in many cases in their series. Few years after the surgery, she started noticing the giving way of patella and lived for 38 years without much disability. J Bone Joint Surg Br.
Femoral supracondylar osteotomy for genu valgum can be performed using an open or closed technique, but the latter has been associated with postoperative joint stiffness 7.
We believe that clinical improvement of habitual dislocation of the patella can be obtained with correction of soft tissue imbalance and contracture and realignment of the patello femoral and tibiofemoral joints.
Treatment of habitual dislocation of patella in an adult arthritic knee
Knee Surg Sports Traumatol Arthrosc. An open surgery procedure was performed. Long term follow up results. Upper tibial osteotomy for osteoarthritis.
He noted that in recurrent dislocation, the medial stabilization of the patella was poor because of weakness of the vastus medialis, dysplasia, generalized joint laxity, or post traumatic medial capsular laxity. To prevent this, always lateral release is combined with medial augmentation. Table of Contents Alerts. Vastus intermedius was inspected and divided if tight. However it may present in childhood with features of dysfunction and inability to run because of instability.
We believe that the soft tissue surgery as primary procedure will buy additional time for patient to delay the TKA and proper soft tissue balancing will improve the longevity and clinical outcome of the definitive haabitual. He noted that a number of bony deformities can be associated with dislocations of the patella, but may not be the actual cause.
Case Presentation A year-old man consulted for limping. Femoral anteversion on CT scan was identical to the contralateral side.
Habitual dislocation of patella: A review
There were no scars on the knee. The histological studies in cases of habitual dislocation of patella have consistently shown degeneration of striated muscle and replacement with varying amounts of fibrous and adipose tissue. Jeffreys in described an abnormal attachment of the iliotibial tract to the patella, producing habitual dislocation in flexion.
In adults, if genu valgum deformity remains after realignment due to the unstable patella, symptoms may also persist.