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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Initially patient had extensor lag of 15 degrees as she was immobilized in flexion.

Treatment of habitual dislocation of patella in an adult arthritic knee

Morphological assessment of the patellofemoral compartment did not reveal any signs of dysplasia. A number of patients had history of intramuscular injections in the thigh in the neonatal period leading to contractures later on. After confirming patellar centering during 4 to 6 flexion-extension cycles, the suture anchor was secured in its final position.

Two-staged procedure was planned, first with patellar realignment and later with definitive total knee arthroplasty. The authors declare that there is no conflict of interests regarding the publication of this paper.

Knee mobilization and full weight bearing was started after four weeks. We believe that the soft tissue surgery as primary procedure will buy additional time for patient to delay the TKA and proper soft tissue balancing will improve the longevity and clinical outcome of the definitive procedures.

Influence of soft tissue structures on patellar three dimensional tracking. After pulling a suture through the pate,la the femoral attachment point was found and with the help of a temporary pin in the medial epicondyle, favorable anisometry could be obtained the graft relaxed as the knee was flexed and a Corkscrew suture anchor Arthrex, Naples, FL, USA was put in place.


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Combined proximal and distal realignment procedures to treat the habitual dislocation of dislocatioh patella in adults. It is also termed as obligatory dislocation as the habiitual dislocates completely with each flexion and extension cycle of the knee and the patient has no control over the patella dislocating as he or she moves the knee 1.

There was full range of motion Figures 4 and 5. Recurrent dislocation of the patella. He also put forward the idea that quadriceps contracture may sometimes give rise to dislocation of the patella.

There was no evidence of patellar maltracking or instability on detailed physical examination. Open in a separate window.

Case Reports in Orthopedics

Then the ipsilateral gracilis tendon was harvested at its distal insertion with a tendon stripper. A few complications were seen that included wound haematoma, lateral popliteal nerve palsy and wound dehiscence.

A cause of limited knee flexion and elevation of the patella.

The main cause of this deterioration was the onset or worsening of patella-femoral joint pain, but no patellar instability. No single procedure has shown to be effective in the management of habitual dislocation of patella and a combination of procedures involving proximal and distal reconstruction are recommended.


A few recurrences were seen. Marmor was the first to patepla TKA in an adult patient with congenital dislocation of the patella without reconstructing the extensor mechanism. When patella or femoral condyles show severe degenerative changes, patellectomy is advocated Macnab, Recurrent dislocation of the patella due to abnormal attachment of the ilio-tibial tract. MPFL reconstruction alone seems effective in habitual posttraumatic patellar dislocation in adults without any associated bone anomalies.

Report of three cases. View at Google Scholar T.

Treatment of habitual dislocation of patella in an adult arthritic knee

The corrective surgery for habitual dislocation involved release of any superolateral contracture, until the patella remained in the intercondylar groove in the fully flexed position of the knee. Further flexion is then possible only if the patella is duslocation to dislocate, when a full range of motion is readily obtainable. Other abnormalities including a shallow femoral groove, hypoplastic lateral femoral condyle, and lateral insertion of the patella tendon were also noted.

They also recommended that various soft tissue procedures are necessary in combination for the correction of habitual dislocation of patella in adults with high grade patella-femoral chondromalacia. Quadriceps tendon was lengthened using V Y plasty at aponeurotic junction.

In case of stiffness or associated bone anomalies trochlear dysplasia, patella alta other therapeutic procedures would be necessary.