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.
Vastus lateralis fibrosis in habitual patella dislocation: Clinical photographs showing functional outcome a walking down the stairs b sitting cross legged.
Redislocation was seen in a few cases and was due to either rectus lengthening not being performed at initial surgery or failure to realign distally when a lateral patellar tendon insertion was detectable clinically, or reformation of contractures.
The surgery included lateral release, advancement of medial retinaculum, and the anteromedial tibial tubercle transfer. In adults there may be a painful knee due to habitual dislocation and arthritis.
Habitual dislocation of patella: A review
Determination of the factors permits an effective elective treatment plan and it has dislication known that satisfactory or significant treatment results can be obtained with combined procedures,[ 6 ] not with a single procedure. A number of reconstructive procedures have been described in the literature for the management of patellar instability. The graft was tense close to extension and relaxed during flexion. Total knee arthroplasty for gonarthrosis with patellar dislocation.
The lateral patellar retinaculum and the synovium were divided and vastus lateralis was detached from the quadriceps tendon, leaving habituaal rim of tendon for suturing. Dislocatiin was not seen in cases with history of trauma. The distinction between these groups is important as the surgical treatment for each group is quite different. Introduction The origin of recurrent patellar instability is patela posttraumatic. Radiological examination revealed evidence of patella alta as defined by Insall and Salvati,[ 7 ] and Q angle was 18 degrees.
Few cases of habitual dislocations have been reported [ 7 ].
Treatment of habitual dislocation of patella in an adult arthritic knee
Second look arthroscopy performed after 1 year of surgery showed no obvious deterioration of the patellar cartilage.
Quadricepsplasty, medial patello-femoral ligament reconstruction, lateral release and tibial tuberosity transfer was done as primary procedure and total knee arthroplasty, which was planned as vislocation procedure, was deferred as the patient improved functionally. He noted that habitual dislocation was not seen in all cases in which vastus lateralis and the iliotibial tract were contracted.
This article has been idslocation by other articles in PMC. Case Presentation A year-old man consulted for limping. Traditionally, habitual dislocation has been treated in the same way as recurrent dislocation except for the need for lengthening of the quadriceps tendon.
Combined proximal and distal realignment procedures to treat the habitual dislocation of the patella in adults. Arch Orthop Trauma Surg. J Bone Joint Surg Am. Williams described the surgical procedure for realignment of soft tissues in habitual patellla of patella. The etiology of quadriceps contracture in children. Placing weight on one foot resulted in lateral patellar dislocation, and squatting was impossible. There was no evidence of patellar maltracking or instability on detailed physical examination.
Habitual dislocation of patella is a condition where the patella dislocates whenever the knee is flexed and spontaneously relocates with extension of the knee.
To receive news and publication updates for Case Reports in Orthopedics, enter your email address in the box below. A discussion on the etiology and relationship to recurrent dislocation of the patella. Patella reduced after release of Iliotibial tract and vastus lateralis.
This generally comprised a dense, disllocation band running along its lower border. EMG studies of vastus lateralis, vastus medialis and pes anserinus muscles were performed in all cases.
Most authors have reported habitual dislocation in association with shortening of the quadriceps gabitual, and consider that lengthening of the tendon is an essential part of the procedure to allow the patella to remain reduced after the realignment.
Surgical management of congenital and habitual dislocation of the patella. These included either lateral retinacular release or proximal or distal realignment.
The authors declare that there is no conflict of interests regarding the publication of this paper. National Center for Biotechnology InformationU. The rest of the clinical examination, in particular the neurological, muscular, and tendon results were normal. Combined proximal and distal realignment procedures to treat the habitual dislocation of the patella in adults.
Although the patella was in the femoral trochlear groove in extension, it dislocated laterally with 25 degrees of knee flexion. Abnormal bands and connections in the tendinous insertion of the quadriceps were found, and were thought to be of congenital origin.
In contrast to other studies, they found that normal patellar tracking was maintained without lengthening of the quadriceps tendon in all cases.
A flat patellar undersurface and flat femoral groove were commonly dislocatikn at review but did not prevent a successful outcome. There was no leg-length discrepancy.
No single procedure has shown to be effective in the management of habitual dislocation of patella and a combination habihual procedures involving proximal and distal reconstruction are recommended. No single procedure is fully effective in the surgical treatment of habitual dislocation of patella and a combination of procedures is recommended.
In our case, the patient was habituual year-old female with moderate degeneration and an active lifestyle. Influence of soft tissue structures on patellar three dimensional tracking. Congenital dislocation of the patella. Various pathological factors have been described in the pathogenesis of habitual dislocation of patella.
During surgery the tight lateral bands were released from the patella and the incision was continued proximally, lateral to the rectus femoris tendon, thus fully dislocatiob the vastus lateralis.
Privacy & Cookies Policy
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.