Abstract
Background: Habitual dislocation of the patella (HDP) is a rare condition. Many surgical procedures using proximal realignment have been reported to treat HDP in children, with around 80% satisfactory results. However, few articles have addressed the treatment of HDP associated with high-grade patellofemoral chondromalacia in adults. Hypothesis: A combination of proximal and distal realignment procedures of the patella will reduce pain and increase function in adult patients with HDP. Study Design: Case series; Level of evidence, 4. Methods: Twelve patients with 13 symptomatic cases of HDP of the knee underwent surgical treatment that included lateral release, medial retinaculum advancement, and the anteromedial tibial tubercle transfer procedure. The average period between dislocation and surgery was 10.8 years. One patient had an additional procedure, an open-wedge varus corrective osteotomy of the distal femur, because of a 20° valgus deformity of the knee. The patellofemoral morphology study included routine and Merchant views of the knee and a computed tomography scan at full extension and at 30° flexion of the knee, before the operation and at follow-up. Any associated intra-articular pathologic findings during the surgical procedure were addressed. Patellofemoral function was evaluated with the Kujala functional score before surgery and at the time of the final follow-up. Results: Chondromalacia of the patella over the medial facet and central ridge was grade III in 8 knees and grade IV in 5 knees. Corresponding chondral erosion of the lateral femoral condyle was noted in every knee. All patients were followed for an average period of 67.3 months (range, 25-103 months). The average preoperative Kujala functional score was 43.9 and the average postoperative score was 88.9 (P
| Original language | English |
|---|---|
| Pages (from-to) | 2101-2108 |
| Number of pages | 8 |
| Journal | American Journal of Sports Medicine |
| Volume | 35 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2007 |
| Externally published | Yes |
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Keywords
- Distal realignment
- Habitual patellar dislocation
- Patellar instability
- Proximal realignment
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Orthopedics and Sports Medicine
- Physical Therapy, Sports Therapy and Rehabilitation
Cite this
Combined proximal and distal realignment procedures to treat the habitual dislocation of the patella in adults. / Shen, Hsain Chung; Chao, Kuo Hua; Huang, Guo Shu; Pan, Ru Yu; Lee, Chian Her.
In: American Journal of Sports Medicine, Vol. 35, No. 12, 12.2007, p. 2101-2108.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Combined proximal and distal realignment procedures to treat the habitual dislocation of the patella in adults
AU - Shen, Hsain Chung
AU - Chao, Kuo Hua
AU - Huang, Guo Shu
AU - Pan, Ru Yu
AU - Lee, Chian Her
PY - 2007/12
Y1 - 2007/12
N2 - Background: Habitual dislocation of the patella (HDP) is a rare condition. Many surgical procedures using proximal realignment have been reported to treat HDP in children, with around 80% satisfactory results. However, few articles have addressed the treatment of HDP associated with high-grade patellofemoral chondromalacia in adults. Hypothesis: A combination of proximal and distal realignment procedures of the patella will reduce pain and increase function in adult patients with HDP. Study Design: Case series; Level of evidence, 4. Methods: Twelve patients with 13 symptomatic cases of HDP of the knee underwent surgical treatment that included lateral release, medial retinaculum advancement, and the anteromedial tibial tubercle transfer procedure. The average period between dislocation and surgery was 10.8 years. One patient had an additional procedure, an open-wedge varus corrective osteotomy of the distal femur, because of a 20° valgus deformity of the knee. The patellofemoral morphology study included routine and Merchant views of the knee and a computed tomography scan at full extension and at 30° flexion of the knee, before the operation and at follow-up. Any associated intra-articular pathologic findings during the surgical procedure were addressed. Patellofemoral function was evaluated with the Kujala functional score before surgery and at the time of the final follow-up. Results: Chondromalacia of the patella over the medial facet and central ridge was grade III in 8 knees and grade IV in 5 knees. Corresponding chondral erosion of the lateral femoral condyle was noted in every knee. All patients were followed for an average period of 67.3 months (range, 25-103 months). The average preoperative Kujala functional score was 43.9 and the average postoperative score was 88.9 (P
AB - Background: Habitual dislocation of the patella (HDP) is a rare condition. Many surgical procedures using proximal realignment have been reported to treat HDP in children, with around 80% satisfactory results. However, few articles have addressed the treatment of HDP associated with high-grade patellofemoral chondromalacia in adults. Hypothesis: A combination of proximal and distal realignment procedures of the patella will reduce pain and increase function in adult patients with HDP. Study Design: Case series; Level of evidence, 4. Methods: Twelve patients with 13 symptomatic cases of HDP of the knee underwent surgical treatment that included lateral release, medial retinaculum advancement, and the anteromedial tibial tubercle transfer procedure. The average period between dislocation and surgery was 10.8 years. One patient had an additional procedure, an open-wedge varus corrective osteotomy of the distal femur, because of a 20° valgus deformity of the knee. The patellofemoral morphology study included routine and Merchant views of the knee and a computed tomography scan at full extension and at 30° flexion of the knee, before the operation and at follow-up. Any associated intra-articular pathologic findings during the surgical procedure were addressed. Patellofemoral function was evaluated with the Kujala functional score before surgery and at the time of the final follow-up. Results: Chondromalacia of the patella over the medial facet and central ridge was grade III in 8 knees and grade IV in 5 knees. Corresponding chondral erosion of the lateral femoral condyle was noted in every knee. All patients were followed for an average period of 67.3 months (range, 25-103 months). The average preoperative Kujala functional score was 43.9 and the average postoperative score was 88.9 (P
KW - Distal realignment
KW - Habitual patellar dislocation
KW - Patellar instability
KW - Proximal realignment
UR - http://www.scopus.com/inward/record.url?scp=36249020393&partnerID=8YFLogxK
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U2 - 10.1177/0363546507305014
DO - 10.1177/0363546507305014
M3 - Article
VL - 35
SP - 2101
EP - 2108
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
SN - 0363-5465
IS - 12
ER -