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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The height of the patella was normal with no recurvatum.

If full flexion is still not possible, either the patwlla intermedius tendon requires division or the tendon of rectus femoris needs elongation. Hence, TKR was an option and we had decided to go for staged procedures – initially getting the normal patellar tracking and later TKR. The first line therapeutic strategy was surgical.

Surgical Treatment of Habitual Patella Dislocation with Genu Valgum

Lengthening of the rectus femoris tendon was also required in many cases in their series. Author information Copyright and License information Disclaimer. Habitual dislocation is associated with shortening of the quadriceps pate,la and considering that lengthening of the tendon is an essential part of the procedure to allow the patella to remain reduced after realignment.

xislocation The patient had a history of femoral growth plate fracture treated conservatively at 13 years of age. However, it has been known that combined procedures, not one single procedure, should be performed to achieve relatively dislocayion treatment results.


A lateral retinacular release and an open-wedge distal fermoral varus osteotomy were followed by additional procedures including lateral release and medial reefing because dislocation was still present after the osteotomy. National Center for Biotechnology InformationU. Proximal soft tissue realignment procedures including lateral release and medial reefing and distal realignment procedures are commonly used in adults.

After confirming patellar centering during 4 to 6 flexion-extension cycles, the suture anchor was secured in its final position.

Habitual dislocation of patella: A review

Surgical management of congenital and habitual dislocation of the patella. It usually presents after the child starts to walk, and is often well tolerated in children, if it is not painful. Hnevkovsky O, Prague, Czechoslovakia Dislocaton fibrosis of the vastus intermedius muscle in children: An anatomic radiographic study. In later childhood they present with habitual dislocation of the patella.

Treatment of habitual dislocation of patella in an adult arthritic knee

Few cases of habitual dislocations have been reported [ 7 ]. On the femoral side, there was no crossing sign or spurs, and the depth of the trochlear groove was normal. The most important factor is contracture of soft tissues lateral to patella.

In habitual dislocation, where flexion of the knee was always associated with displacement of the patella, both lateral contractures and medial laxity were present. If it was not hanitual 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. During surgery, he found that there were well defined bands, or muscular contractures within the quadriceps in each case.


Considering that the risk of joint stiffness would be high in our patient because of the complex procedures including lateral retinacular release and medial reefing, we used an open osteotomy technique and took care not to damage the joint capsule during surgery. A report of two cases. Placing weight on one foot resulted in lateral patellar dislocation, and squatting was impossible. The patlla retinaculum was thickened while the medial retinaculum was thinned.

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Family history of dislocation was positive in a few patients and other abnormalities were noticed in some cases. Histological examination in these cases revealed inflammatory cell infiltration, fibrosis and muscle fibre degeneration.

Surgical Treatment of Habitual Patella Dislocation with Genu Valgum

Open in a separate window. In other words it is essential to lengthen the quadriceps above the patella rather than to shorten it below the patella. Proximal realignment is the most effective treatment for reduction of patellar dislocation. Few years after the surgery, she started noticing the giving way of patella and lived for 38 years without much disability.