Recurrent Dislocation and Subluxation of the Patella: Experience of 22 Knees

Seong, Sang Cheol; Chung, Phil Hyun; Kim, In Joon; Lee, Myung Chu

Abstract

Recurrent dislocation of the patella is a relatively uncommon disease, which is most commonly seen in females in late adolescence. The condition is usually spontaneous and only rarely fallows traumatic dislocation. Dislocation is nearly always lateral and about one thirdis bilateral. The theoretical rationale of the treatment of the recurrent dislocation and subluxation of the patella is the realignment of the extensor mechanisms. We experienced with recurrent dislocation and subluxation of the patella on 22 knees in 18 patients at Seoul National University Hospital from July 1981 to Oct. 1987 and obtained the following results. 1. The age at operation ranged from 4 to 33 years and its mean was 15.8 years. Among 18 patients thirteen were female and five, male. 2. The most common presenting symiptom was pain (11 knees) and the most common presenting sign was quadriceps muscle atrophy (11 knees). 3. The prominent radiologic finding was patella alta in 6 knees (27.3%), genu valgum in 10 knees (45.3%), and hypoplasia of the lateral condyle of the femur in 2 cases (9%). 4. In two knees supracondylar osteotomy were performed and followed by proximal extensor mechanism realignment. In twelve knees only proximal reconstruction was performed. Four knees were treated by Hauser's technique and three knees with Roux-Gold-thwait technique. And these distal reconstruction procedures were performed with other procedures. 5. Mean follow up period was 1 year and 5 months. And the results are excellent in 8 knees, good in 12 knees and fair in 2 knees.