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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. 1. Case Presentation Habitual Dislocation of Patella Dr Sushil Sharma First Year MS Orthopaedic Resident; 2.

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Physical examination did not reveal general joint laxity or malalignment of the lower extremity. If full flexion of knee is possible at this stage, vastus is repaired and the wound is closed.

J Bone Joint Surg Br. Tight fibrous bands between Iliotibial tract and patella. It is usually asymptomatic and is often detected by the parents as an odd looking knee or is detected on routine examination in many children. Preoperative patellofemoral Habituual, tangential view in neutral rotation: Abstract Habitual patellar dislocations are rare in adults.

Treatment of habitual dislocation of patella in an adult arthritic knee

In our case, the patient was a year-old female with moderate degeneration and an active lifestyle. This generally comprised a dense, fibrous band running along its lower border. If it was not possible to fully flex the knee at this stage, rectus femoris with or without vastus intermedius was lengthened to achieve reduction in full flexion of the knee. The cislocation line therapeutic strategy was surgical.

Various surgical techniques have been reported to treat pediatric population. He reported replacement of the patella be avoided in adult patients with congenital dislocation of the patella if they can function reasonably well. The lateral patellar retinaculum and the synovium were divided and vastus lateralis was detached from the quadriceps tendon, leaving a rim of tendon for suturing.


Shen performed combined proximal and distal procedure in 12 adult patients with habitual dislocation of patella. Operative procedure With patient in supine position under epidural anesthesia, an anterior midline knee incision was used with paramedian arthrotomy.

There were no scars on the knee. Habitual dislocation of patella, dislocatioh release, medial patello-femoral ligament, reconstruction, quadricepsplasty, tibial tuberosity transfer. They found that vastus medialis was so deficient that muscle advancement was not possible. Isolated repair of MPFL was possible because there was no retraction of the knee extensor apparatus or predisposing bone disocation, which would have required further surgical procedures.

An open surgery procedure was performed.

Contracture of the vastus intermedius in children. They performed arthroscopy in all cases and found that chondromalacia cislocation the patella grade III to grade IV was present in all cases.

Treatment of habitual dislocation of patella in an adult arthritic knee

Radiological examination revealed evidence of patella alta as defined by Insall and Salvati,[ 7 ] and Q angle was 18 degrees. During surgery, he found that there were habutual defined bands, or muscular contractures within the quadriceps in each case. Very little literature is available on habitual dislocation of patella as most of the studies have combined cases of recurrent dislocation with habitual dislocation. The distinction between these groups is important as the surgical treatment for each group is quite different.

On the femoral side, there was no crossing sign or spurs, and the depth of the trochlear groove was normal. They also recommended that various soft tissue procedures are necessary in combination for the correction habitaul habitual dislocation of patella in adults with high grade patella-femoral chondromalacia.

Williams reported clinical presentations and pathophysiology in patients with quadriceps contractures. In our patient, radiographic results have shown that instability was not caused by bone anomalies. To receive news and publication updates for Case Reports in Orthopedics, enter your email address in the box below. They recommended early surgery and dislocayion gradual improvement in the development of the femoral trochlear groove in response to the re-centering of the patellar mechanism.


The diagnostic relevance of Q angle as an indication for distal realignment was not established in our case and we recommend tibial tuberosity-trochlear groove distance TTTG as measured by CT scan as a better tool. Many surgical procedures using proximal realignment and distal realignment have been reported to treat HDP in children with satisfactory results. In case of stiffness or associated bone anomalies trochlear dysplasia, patella alta other therapeutic procedures would be necessary.

There was no associated leg dysplasia. Permanent patellar dislocation, either congenital or acquired, is diagnosed at an early age in childhood and numerous surgical techniques have been introduced for its treatment.

Habitual dislocation of patella is never obvious in the young, fat-covered knee and may be missed unless actively paatella. At 4 months of follow-up, the patient was able to work normally as construction worker in public works.

Long-term outcome of surgically treated habitual patellar dislocation in children with coexistent patella alta: We adjusted the length of the graft by taking into account engagement of the patella and by obtaining full range of motion in the knee. The contractures were mainly seen in the vastus lateralis the main contributor in over half the cases and rarely in the iliotibial band or rectus femoris.

Congenital dislocation of the patella.