scholarly journals Recurrent Dislocation of the Patella

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0025
Author(s):  
Gustavo Benítez
Keyword(s):  
Recurrent Dislocation ◽  
Good Alternative ◽  
Mpfl Reconstruction ◽  
Lateral Release ◽  
Vastus Medialis ◽  
Kujala Score ◽  
Mid Term Results ◽  
Dislocation Of The Patella ◽  
Main Complication

Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved from 46,54 pts. preoperative to 88,36 postoperative. Our main complication was 1 patient with rigid knee, who required movilization under anesthesia and arthroscopic arthrolisis to improve her outcome. Conclusion: The combination of this techniques are a good alternative to treat patients with recurrent patella disclocation, with good short and mid-term results. Biomechanic intra and postop complications of MPFL reconstruction are related to patellar fixation, anatomic positioning of femoral tunnel and knee position of the graft fixation.

Modified Elmslie–Trillat Procedure for Recurrent Dislocation of the Patella

2016 ◽  
Vol 30 (05) ◽  
pp. 493-500 ◽  
Author(s):  
Genya Mitani ◽  
Takashi Maeda ◽  
Tomonori Takagaki ◽  
Kosuke Hamahashi ◽  
Kenji Serigano ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Recurrent Dislocation ◽  
Postoperative Outcomes ◽  
Q Angle ◽  
Tilting Angle ◽  
Kujala Score ◽  
The Mean ◽  
Dislocation Of The Patella

AbstractMany groups have reported good to excellent clinical outcomes of the Elmslie–Trillat (ET) procedure for recurrent dislocation of the patella. However, the mean follow-up period of these studies was no more than 5 years. We hypothesized that the long-term postoperative outcomes of the modified ET procedure for recurrent dislocation of the patella would be acceptable compared with those of other procedures. The long-term postoperative outcomes of patients treated with the modified ET procedure were examined. A total of 31 knees in 27 patients with recurrent dislocation of the patella who underwent a modified ET procedure (without medial capsular plication) were evaluated. The mean follow-up period was 13.0 years. Pre- and postoperative radiographs were examined to determine the Q-angle, tilting angle, lateral shift ratio, sulcus angle, congruence angle, and Insall–Salvati index. Clinical outcomes were evaluated based on the Fulkerson patellofemoral joint evaluation score, Kujala score, and the presence of the apprehension sign. Radiological evaluation revealed significant postoperative improvements in the Q-angle, tilting angle, lateral shift ratio, congruence angle, Kujala score, and Fulkerson score (p < 0.001). Sixty-eight percent of all patients had a “good” or “excellent” Fulkerson score. The apprehension sign continued to be shown for six knees. Progression of osteoarthritic changes was observed in three knees, and one knee was symptomatic. The modified ET procedure provided satisfactory outcomes based on radiological and clinical evaluations. These results show the long-term effectiveness and safety of the modified ET procedure for recurrent patellar dislocation.

scholarly journals Recurrent Dislocation of the Patella in Kabuki Make-Up Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Lucie Rouffiange ◽  
Jean-Paul Dusabe ◽  
Pierre-Louis Docquier
Keyword(s):  
Postoperative Complication ◽  
Patellar Dislocation ◽  
Recurrent Dislocation ◽  
Tibia Fracture ◽  
Tibial Tuberosity ◽  
Vastus Medialis ◽  
Kabuki Syndrome ◽  
Surgical Results ◽  
Ligamentous Laxity ◽  
Dislocation Of The Patella

Two patients with Kabuki make-up syndrome with bilateral recurrent dislocation of the patella are presented. They had generalized ligamentous laxity and patellofemoral dysplasia. Both developed patellar dislocation in adolescence and required surgery, with medial transfer of the tibial tuberosity associated with vastus medialis plasty (Insall technique). One postoperative complication occurred in one case: a nondisplaced tibia fracture at the sixth postoperative week that healed with conservative means. Final results were good in both cases. Good surgical results can be achieved in patellar dislocation in patients with Kabuki syndrome.

scholarly journals Medial patellofemoral ligament reconstruction for patellofemoral instability: a new surgical technique

2021 ◽  
Vol 7 (4) ◽  
pp. 843
Author(s):  
Shreekantha K. S. ◽  
Mohammed Usman ◽  
Deepak Malik ◽  
Mahammad Aseem ◽  
Mohammad Gous Mulla
Keyword(s):  
Surgical Technique ◽  
Functional Outcome ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Patellofemoral Instability ◽  
Lysholm Score ◽  
Mpfl Reconstruction ◽  
Kujala Score ◽  
New Surgical Technique

<p class="abstract"><span lang="EN-US">The purpose of this study was to present new surgical technique for MPFL reconstruction. We also describe its functional outcome, complications, and the advantages of the procedure. This study is a prospective analysis of collected data during the period of august 2018 to January 2020. Ten cases of patients with recurrent symptomatic patellar instability and who underwent isolated MPFL reconstruction were included in the study. Kujala scoring and lysholm scoring was done to assess the functional outcome at follow-up. Post-operative dislocation and apprehension were recorded in each case along with any complication. Pre-operative Kujala score was 36.80 which improved to 89.80 postoperatively at the time follow-up. Pre-operative lysholm score was 36.80 which improved to 92.70 postoperatively at the time follow-up. The improvement in Kujala score and Lysholm score was found to be highly significant (p&lt;0.01). We have done a simple technique where MPFL is reconstructed anatomically to restore kinematics and stability. Consistent good results with early rehabilitation can be obtained using the described technique.</span></p>

scholarly journals Use of hyaluronic acid injection after arthroscopic release in lateral patellar compression syndrome with degenerative cartilage changes: randomized control trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sherwan A. Hamawandi
Keyword(s):  
Hyaluronic Acid ◽  
Knee Pain ◽  
Lateral Release ◽  
Arthroscopic Release ◽  
Compression Syndrome ◽  
Kujala Score ◽  
Group A ◽  
Lateral Patellar Compression Syndrome ◽  
Degenerative Cartilage

Abstract Background Degenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes. Method Ninety patients age (30–50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intraarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months. Results There was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value< 0.001) with better improvement in Kujala score in group A after intra-articular injection of Hyaluronic acid up to 2 year of follow up (P-value = 0.006) as well as better improvement in visual analogue score at 6 months post-operatively (P-value = 0.035). Conclusion Intra-articular injection of Hyaluronic acid after arthroscopic release, in patients with lateral patellar compression syndrome and degenerative cartilage changes, can result in better improvement of knee pain and functional outcome up to 2 years of follow up. Trial registration NCT, NCT04134611. Registered 18 October 2019 -Retrospectively registered.

Anatomical Medial Patellofemoral Ligament Reconstruction for Recurrent Patella Dislocation: Two-Strand Grafts versus Four-Strand Grafts

2019 ◽  
Author(s):  
Jinghui Niu ◽  
Wei Lin ◽  
Qi Qi ◽  
Jiangfeng Lu ◽  
Yike Dai ◽  
...  
Keyword(s):  
Tilt Angle ◽  
Medial Patellofemoral Ligament ◽  
Lysholm Score ◽  
Mpfl Reconstruction ◽  
Patella Dislocation ◽  
Reconstruction Method ◽  
Patellar Tilt ◽  
Kujala Score ◽  
Patellar Tilt Angle

AbstractThe purpose of this study was to describe two anatomical medial patellofemoral ligament (MPFL) reconstruction methods: reconstruction with two-strand grafts and reconstruction with four-strand grafts and to evaluate the clinical and radiological results. From January 2010 to January 2013, patients who sustained recurrent patella dislocation and met inclusion criteria were included in the study and divided into two groups randomly to undergo MPFL reconstruction either by two-strand grafts (T group) or four-strand grafts (F group). Patients were followed up 1 month, 1 year, 2 years, and 3 years postoperatively. The apprehension test was applied to test patella stability. The Kujala score, Lysholm score, and Crosby–Insall grading were used to evaluate the function of the affected knee. The patellar congruence and patellar tilt angle were used to measure the morphology of the patellofemoral joint. In addition, patients' subjective assessments and complications were recorded. Thirty-eight patients in T group and 38 patients in F group were followed for at least 36 months. The apprehension test was positive in all patients preoperatively but was negative at follow-up. The Kujala score, Lysholm score, patellar congruence angle, and the patellar tilt angle of patients in both groups improved significantly at 36-month follow-up when compared with those assessed preoperatively. However, patients in the F group achieved better clinical results in terms of Kujala score, patellar congruence angle, patellar tilt angle, and Crosby–Insall grading when compared with those in the T group 3 years after the operation. Most patients (92% of patients in the T group and 97% of patients in the F group) were satisfied with the surgery. The anatomical MPFL reconstruction with two-strand grafts or four-strand grafts were both safe techniques for recurrent patella dislocation with satisfactory clinical outcomes. The anatomical fixation with four-strand grafts achieved better clinical and radiographic results in the follow-up, which may be a better reconstruction method.

Medial Patellofemoral Ligament Reconstruction in Traumatic Patellar Dislocation without Patellar Fixation

2019 ◽  
Vol 33 (10) ◽  
pp. 998-1003
Author(s):  
Samir Abdulrazik Ibrahim ◽  
Emad Mureed Shohdy ◽  
Sami Abdulghaffar Ramadan ◽  
Abdulrahman Khalid Almisfer ◽  
Wael Shoabe Abdulsattar ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
International Knee Documentation Committee ◽  
Clinical Results ◽  
Mpfl Reconstruction ◽  
Traumatic Rupture ◽  
Spontaneous Reduction ◽  
Kujala Score ◽  
History Of ◽  
Recurrent Patellar Instability

AbstractAcute traumatic patellar dislocation is a common injury, and spontaneous reduction may occur at the time of injury or may be reduced at the field of the accident by someone. It may be associated with osteochondral fractures and rupture of medial patellar stabilizers leading to recurrent patellar instability. The aim of this prospective study was to evaluate the outcomes of medial patellofemoral (PF) ligament (MPFL) reconstruction in recurrent traumatic patellar dislocation. Forty-five patients presented with PF instability as a result of traumatic rupture MPFL with normal patellar tracking underwent MPFL reconstruction without patellar fixation hardware through two parallel transpatellar tunnels and one screw in femoral tunnel. All patients were evaluated clinically preoperatively and at a minimum follow-up of 24 months, and International Knee Documentation Committee (IKDC) and Kujala scores were used to assess the clinical results. All patients were available for evaluation at a minimum of 24 months (up to 36 months). The mean age of these patients at the time of surgery was 22.82 years (range: 18–34 years). All patients gave history of trauma of their knees. Mean IKDC scale showed significant improvement as it rose from 47.17 preoperatively to 77.94 postoperatively, and mean Kujala score rose from 53.88 preoperatively to 86.24 postoperatively (p < 0.001). No recurrence of dislocation was recorded. Only three patients had mild atrophy of thigh and one patient had some difficulty in jumping. Reconstruction of MPFL by this method provides good clinical result in the treatment of PF instability by using autologous graft (semitendinosus and gracilis). Less hardware were used with less complications.

scholarly journals Extensive Lateral Release and Medial Patello-femoral Ligament Reconstruction in 25 years of Chronic Fixed Lateral Patellar Dislocation: A 5 year follow up Case Report

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0048
Author(s):  
Andri Lubis ◽  
Petrus Aprianto ◽  
Yudistira P. Siregar
Keyword(s):  
Case Report ◽  
Patellar Dislocation ◽  
Femoral Tunnel ◽  
Mpfl Reconstruction ◽  
Lateral Release ◽  
Modified Technique ◽  
Lateral Dislocation ◽  
Cortical Screw ◽  
Lateral Patellar Dislocation

Objectives: Chronically fixed lateral patellar dislocation is uncommon and mostly associated with disruption of the medial patellofemoral ligament (MPFL) which is a major risk factor for this condition, as it functions as the main patella medial stabilizer. This paper focuses on the reconstruction of the MPFL after an extensive lateral release in a fixed lateral patellar dislocation. We aim to explain the technique that was used to reduce and maintain the position of the patella and prevent it from re-dislocation. Extensive lateral release and modified MPFL reconstruction for a chronically fixed patellar lateral dislocation provide a satisfactory result. We aim to explain a modified technique to treat a chronically fixed patellar lateral dislocation Case presentation: We present a case report of a 49-year-old Caucasian male with a history of falling on his right knee 25 years before. He complained of pain on his knee for 8 months before. Physical examination showed chronically fixed lateral patellar dislocation with a normal range of motion. The diagnosis of patellar dislocation was confirmed with a conventional radiograph. The patient underwent extensive lateral release of the knee followed by a modified technique for MPFL reconstruction. Semitendinosus tendon was used as the graft because of the chronic nature of this condition. The graft was inserted into the patellar tunnel and fixed using endobutton®. The graft was inserted into the femoral tunnel that was made at Schottle point from the medial through the lateral side. After that, the cortical screw with the washer was inserted on the lateral femoral side just above the femoral tunnel as an anchor to make sure the tendon is secured. We follow-up the patient for 5 years. Results and Conclusion: On a 5 year follow-up, there was no complaint of recurrent patellar dislocation. The result of this extensive lateral release followed by modified MPFL reconstruction for a chronically fixed lateral patellar dislocation is satisfactory. The extensive release was needed to reduce the fixed dislocated patella and this modified technique of MPFL reconstruction by using screw and washer as an anchor on lateral sides of the femur could be an alternative to prevent re-dislocation.

scholarly journals Early Results of Patients With Recurrent Patellar Instability Treated With MPFL Reconstruction

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Ömer Naci Ergin ◽  
Mehmet Ekinci ◽  
Fuat Bilgili ◽  
Yücel Bilgin ◽  
Mehmet Aşık
Keyword(s):  
Patellar Dislocation ◽  
Patellar Instability ◽  
Mpfl Reconstruction ◽  
Activity Score ◽  
Vas Score ◽  
Early Results ◽  
Kujala Score ◽  
Patient Reported ◽  
Recurrent Patellar Instability

Introduction: MPFL reconstruction is an evidence-based and successful technique in treating patients with recurrent patellar instability without alignment problems or who have not yet undergone skeletal maturity for distal realignment surgery. Aim: The aim of this study is to report early results of patients who underwent MPFL reconstruction Method: 21 patients with lateral patellar instability who were treated with MPFL reconstruction using hamstring autogrefts in our clinic between 2012 and 2013 were evaluated. Mean age was 18.8 (8-32). Average age of first patellar dislocation was 13 (5-18). Patients’ history of complaints, pre and postoperative knee ROMs, patellofemoral pain scales, and patellofemoral instabilities were evaluated. These evaluations were done using Kujala score, İKDC (International Knee Documentation Committee) score, KOS(Knee Outcome Survey Activities Of Daily Living Score) score, Tegner activity score and VAS score. Results: 86% of our patient reported getting better with the surgery. The mean follow up was 25,2 months.Median Kujala score rose from 71 preop to 96 postop(p<0.05) and median İKDC score rose from 72 to 95(p<0.05). VAS score decreased from 3.4 to 1.2. KOS score was on average 83. Tegner activity score of our patients which was 2.57 preoperatively increased to 4.71. Only one patient had a decreased range of flexion (10 degrees on terminal flexion) and only one patient had persisting recurrent patellar dislocation (%4). The failure to treat this patient was attributed to his concurrent patologies consisting of patella alta, trochlear dysplasia and patellofemoral malalignment. Conclusion: MPFL reconstruction with hamstring autograft for treating patellar instability seems to be an effective surgical option according to early results. For late term results further follow-up is needed.

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