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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Bakshi described the difference in the pathology of recurrent and habitual dislocations. Surgical management of congenital and habitual dislocation of the patella. However it may present in childhood with dysfunction and instability. Hahitual showed good results with improvement of sulcus angle at follow up. Therefore, a reconstruction using a medial patellofemoral ligament allograft was not considered necessary and the reduction was maintained at the follow-up examination.

Habitual dislocation of patella: A review

Femoral supracondylar osteotomy for genu valgum can be performed using an open or dielocation technique, but the latter has been hwbitual with postoperative joint stiffness 7. 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.

These included either lateral retinacular release or proximal or distal realignment. A skyline view of the knee showed lateral dislocation of the patella. A variety of surgical techniques have been introduced for the treatment of habitual dislocation of the patella with genu valgum.

Treatment of habitual dislocation of patella in an adult arthritic knee

Femoral anteversion on CT scan was identical to the contralateral side. The quadriceps was not retracted. Proximal and distal reconstruction of the extensor mechanism for patellar subluxation. No predisposing factor was found [ 4 ].

The lateral retinaculum was thickened while the medial retinaculum was thinned. 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. Proximal realignment is the most effective treatment for reduction of patellar dislocation. Complete flexion was obtained at the 3 rd postoperative week. If full flexion is still not possible, either the vastus intermedius tendon requires division or the tendon of rectus femoris needs elongation.

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Habitual dislocation of the patella is a rare condition among adults, where the patella dislocates during flexion and relocates during extension without pain and swelling unlike the recurrent patellar dislocation.

Similar findings were reported by other authors showing contractures of quadriceps mechanism in cases of habitual dislocation of patella. Four months after surgery the patient has begun working normally.

Treatment of habitual dislocation of patella in an adult arthritic knee

Physical examination did not reveal general joint laxity or malalignment of the lower extremity. A Two year after surgery, normal patella-femoral alignment was achieved.

Abnormal bands and connections in the tendinous insertion of the quadriceps were found, and were thought to be of congenital origin. This was not necessary in patients with recurrent dislocation in whom no such contractures were demonstrated. They found that vastus medialis was so deficient that muscle advancement was not possible. However, it has been known that combined procedures, not one single procedure, should be performed to achieve relatively satisfying treatment results.

Total knee arthroplasty in a patient with congenital dislocation of the patella: Habitual patellar dislocation is a rare condition where the patella dislocates during flexion and relocates during extension unlike chronic patellar dislocation that occurs during both flexion and extension of the knee, and it usually presents without pain or swelling.

Introduction Habitual dislocation of patella is a condition where the patella dislocates whenever the knee is flexed and spontaneously habiitual with extension of the knee. Patella tilt was increased in a lateral view during contraction of the quadriceps but the morphology of the patella was normal. Treatment is difficult, and often associated with significant morbidity. A pstella man visited our institution due to lateral dislocation of the left knee in flexion and instability that had persisted for 7 years Fig.


However, it has been known that combined procedures, not one single procedure, should be performed to achieve relatively satisfying treatment results. Criteria which allowed him to return to work were no pain, stability of the patella, no swelling, and full range of motion.

First lateral retinacular release of the patella was performed. Disorders of patellofemoral joint.

If patella still dislocates after full flexion is achieved, distal realignment is added. Still, the ideal age for the treatment has yet to be established. Few years after the surgery, she started noticing the giving way of patella and lived for 38 years without much disability.

Case Reports in Orthopedics

At final followup two years postoperatively, the patient was pain-free. It is usually symptomatic when detected in adults with major symptom of patella-femoral pain and weakness during running or climbing stairs, crepitus, and joint effusion.

Due to shortening of the extensor mechanism, the patella could not be reduced. Beom Koo Lee, MD. Subscribe to Table of Contents Alerts. The disllocation between these groups is important as the surgical treatment for each group is quite dislocatino. Williams described the surgical procedure for realignment of soft tissues in habitual dislocation of patella. 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.

Therefore, we thought proximal soft tissue realignment alone was not sufficient to realign the patella and performed a femoral supracondylar osteotomy in addition.