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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Habitual dislocation of patella is a rare disorder. Successful results require combination of these procedures, depending on clinical and intraoperative findings on an individual basis.
Predisposing factors include ligamentous laxity, contracture of the lateral patellar soft tissues, patella alta, quadriceps contractures, hypoplasia of the lateral femoral condyle and genu valgum bony factors.
Case Reports in Orthopedics
If patella still dislocates after full flexion is achieved, distal realignment is added. Overall, the cause of dislocation was isolated rupture of the medial stabilizing apparatus of the patella. Femoral anteversion on CT scan was identical to the contralateral side. Several factors predisposing to patellar instability have been described such as trochlear dysplasia disloxation a patella alta [ 4 ]. During surgery, he found that there were well defined bands, or muscular contractures within the quadriceps in each case.
Patella tilt was increased in a lateral nabitual during contraction of the quadriceps but the morphology of the patella was normal. The failed TKA was revised by using constrained-type prosthesis. Received Aug 18; Accepted Sep Williams reported clinical presentations and dizlocation in patients with quadriceps contractures.
Among them, osteotomy combined with proximal soft tissue realignment procedures including lateral release and medial reefing has been commonly performed. Patella reduced after release of Iliotibial tract and vastus lateralis. She complained slight discomfort by an apprehension test, but was not very painful even when dislocated. Bone factors probably had only a small role in idslocation dynamic stability of the patella. In the physical examination, the apprehension test was positive.
Upper tibial osteotomy for osteoarthritis. Journal List Indian J Orthop v. View at Google Scholar J. Surgical management of congenital and habitual dislocation of the patella. When the vastus lateralis and the iliotibial tract are involved there is great tendency for habitual dislocation of the patella to occur on flexion of the knee.
Treatment of habitual dislocation of patella in an adult arthritic knee
Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children. In habitual dislocation, where flexion of the knee was always associated with displacement of the patella, both lateral contractures and medial laxity were haabitual. Support Center Support Center.
In particular, soft tissue procedures should be followed by bony procedures including femoral supracondylar osteotomy in cases of habitual dislocation of the patella with genu valgum. At 4 months of follow-up, the patient was able to work normally as construction worker in public works.
Surgical Treatment of Habitual Patella Dislocation with Genu Valgum
But after dislkcation quadriceps exercises, patient improved without any extensor lag. Various pathological factors have been described in the pathogenesis of habitual dislocation of patella. Appropriate surgical treatment methods for habitual dislocation of the patella with genu valgum still remain controversial. Long-term outcome of surgically treated habitual patellar dislocation in children with coexistent patella alta: During surgery we adjusted graft tension with a pin in the medial epicondyle attachment.
Most cases presented between the ages of 5 and 12 years when the femur is growing disproportionately to the quadriceps.
Total knee arthroplasty in middle-aged patient with habitual dislocation is not a permanent solution. We present a case of neglected iatrogenic habitual patellar dislocation with osteoarthritis in a year-old woman. Habitual dislocation of the patella in flexion. Patella is dislocated when the knee is flexed and reduced in extension.
It dielocation usually asymptomatic and is often detected by the parents as an odd looking knee or is detected on dislocstion examination in many children.
Abstract Habitual dislocation of patella is a condition where the patella dislocates whenever the knee is flexed and spontaneously relocates with extension of the knee.
Habitual dislocation of patella: A review
The major intra-operative finding was contracture of the lateral patellar retinaculum with fibrotic bands in the superolateral aspect of patella. Recurrent dislocation of the patella in the adult: Two holes were drilled into the patellar bone by a medial parapatellar approach.
Open surgery was performed associating lateral retinacular release, reconstruction of the medial patellofemoral ligament with an ipsilateral gracilis tendon graft.
Bakshi described the difference in the pathology of recurrent and habitual dislocations.
In other words it is essential to lengthen the quadriceps above the patella rather than to shorten it below the patella. The height of the patella was normal with no recurvatum. Early results in patients with severe generalised ligamentous laxity and aplasis of the trochlear groove.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.
Erosion of the corresponding lateral femoral condyle was noted in all cases.
Preoperative radiographs anteroposterior a and lateral view b of left knee joint showing degenerative changes. Preoperative patellofemoral X-ray, tangential view in neutral rotation: Tight fibrous bands between Iliotibial tract and patella.