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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Case Reports in Orthopedics

An open surgery procedure was performed. Pathophysiology Various pathological factors have been described in the pathogenesis of habitual dislocation of patella. They recommended that distal procedures alone are certain to fail, and if the procedure involves distal advancement of the tibial tendon the condition will actually be made worse. The passive lateral patellar tilt test was negative since the soft tissue attachment to the lateral border of the patella was diffusely stiff and tight.

Restoration of dynamic stability of the patella by pes anserinus transposition.

J Bone Joint Surg Br. This article has been cited by other articles in PMC. Therefore, a reconstruction using a medial patellofemoral ligament habital was not considered necessary and the reduction was maintained at the follow-up examination. No single procedure has shown to be effective in the management of habitual dislocation of patella and a combination of procedures involving proximal and distal reconstruction are recommended.

The Korean Knee Society. Four months after surgery the patient has begun working normally.

Shen performed combined proximal and distal procedure in 12 adult patients with habitual dislocation of patella. A release of quadriceps femoris contracture can be effective in correcting genu valgum in children who have hypoplasia of the lateral femoral condyle due to growth plate damage 7. They believed that even in the presence of severe ligamentous laxity, development of the trochlear groove could be expected during the remaining growth when the patella is realigned at a young age.

It has been known that significant treatment results can be obtained with combined procedures, not with a single procedure. We present a case of neglected iatrogenic habitual patellar dislocation with osteoarthritis in a year-old woman.


Knee Surg Sports Traumatol Arthrosc. Several dislocatiin predisposing to patellar instability have been described such as trochlear dysplasia or a patella alta [ 4 ]. Am J Sports Med. If patella still dislocates after full flexion is achieved, distal realignment is added. Habitual dislocation of patella, lateral release, medial patello-femoral ligament, reconstruction, quadricepsplasty, tibial tuberosity transfer.

They found that vastus medialis was so deficient that muscle advancement was not possible.

Beom Koo Lee, MD. There was no recurrent dislocation or apprehension. Treatment is difficult, and often associated with significant morbidity.

Surgical Treatment of Habitual Patella Dislocation with Genu Valgum

After confirming patellar centering during 4 to 6 flexion-extension cycles, the habigual anchor was secured in its final position. Support Center Support Center. Dislocation results in irreversible injuries due to lateral translation of the patella [ 12 ]. Overall, the cause of dislocation was isolated rupture of the medial stabilizing apparatus of the patella.

Extensor lag duslocation always present whenever rectus femoris was lengthened which resolved in due course of time with physiotherapy. This band yabitual a rolled anterior border that sweeps forward to the patella rather than having its main attachment to the tibia.

In the physical examination, the apprehension test was positive. He recommended cautious physical examination regarding patella tracking since radiological examinations, including skyline view do not always show the pathophysiology of patellar instability. She complained slight discomfort by an apprehension test, but was not very painful even when dislocated. First-time patellar dislocation with resultant habitual dislocation two years later, which was not demonstrated on plain X-rays halfway: Because the injury was anatomical, conservative treatment with rehabilitation was not proposed.

The irritant quality of the solution varied with its components, pH and osmotic pressure. The first line therapeutic strategy was surgical.

In recurrent dislocations, there were no contractures of the soft tissue lateral to the patella, but medial stabilisation was found to be weak. Various pathological factors have been described in the dislocaation of habitual dislocation of doslocation. Benoit published their series of 12 cases of habitual dislocation of patella with patella alta.


Habitual dislocation of patella: A review

Habitual dislocation is associated with disolcation of the quadriceps muscles and considering that lengthening of the tendon is an essential part of the procedure to allow the patella to remain reduced after realignment. Preoperative radiographs anteroposterior a and lateral view b of left knee joint showing degenerative changes.

Once the knee joint flexion starts, patella tends to dislocate laterally.

In case of stiffness or associated bone anomalies trochlear dysplasia, patella alta other therapeutic procedures would be necessary. It is also termed as obligatory dislocation as the patella dislocates completely with each flexion and extension cycle of the knee and the patient has no control over the patella dislocating as he or she moves the knee 1.

A year-old man consulted for limping. She recalled a childhood surgery over middle third of left thigh incision and drainage. A quadricepsplasty was considered unnecessary because he had no contracture of the quadriceps femoris. Knee mobilization and full weight bearing was started after four weeks. View at Google Scholar T.

Surgical Treatment of Habitual Patella Dislocation with Genu Valgum

Habitual patellar dislocation is a rare condition where the patella dislocates during flexion and relocates during extension unlike chronic patellar dislocation that occurs during both flexion and extension of the knee, and it usually presents without pain or swelling. Recurrent dislocation of the patella in the adult: The main difficulty which could have been encountered during surgery was identifying a flexion deficit after performing reconstruction because of the secondary retraction of the quadriceps.

The patella has been stabilized with extensive proximal release and vastus medialis advancement.

However it may present in childhood with dysfunction and instability.