J Korean Knee Soc.  1999 Jun;11(1):96-100.

Treatment of the Recurrent patellar Subluxation and Dislocation

• Lim HC
• Yoon JR
• Min KK
• Kim SY
• Choi BS

Abstract

PURPOSE: To determine the results of the operative treatment of recurrent subluxation and dislocation of the patella, we have analyzed the clinical and radiologic results of the surgical treatment. MATERIALS AND METHODS: The Crosby and Insalls(1976) clinical grading was used on the basis of the patients own account. From the radiologic evaluation, either the presence or absence of the degenerative changes in patellofemoral joints were determined and congruence angle was measured on 19 patients(28 knees) during 6 years 2months follow up. We performed the three operative method - lateral retinacular release, proximal realignment and distal realignment(Hauser, Elmslie-Trillat operation). Lateral retinacu- lar release and proximal realignment were performed on the patients who were skeletally immatured and Q angle less than 20 degrees. Distal realignment(Hauser, Elmslie-Trillat operation) was applied to patients who were skeletally mature and increased Q angle(more than 20 degrees) RESULTS: The overall clinical results were excellent in 10(36%), good in 16(57%)cases and fair to poor in 2 cases(7%). The radiologic results showed normalization of congruence angles after operative treat- ment except three cases. There was no evidence of patellofemoral joint degeneration. CONCLUSION: For the treatment of recurrent patellar dislocation, age and Q-angle are considering fac- tors. Intraoperatively, determination of the patellar tracking is important. We think that a lateral retinacu- lar release only and proximal realignment produce satisfactory clinical results on the skeletally immature patients, distal realignment(Hauser, Elmslie-Trillat operation) on the skeletally mature and who have increased Q angle over 20.

MeSH Terms

Dislocations*
Follow-Up Studies
Humans
Patella
Patellar Dislocation
Patellofemoral Joint