Head


chapter 10: Patellar Dislocation

REFERENCES

  1. Merkow RL, Soudry M, Insall JN. Patellar dislocation following total knee replacement. J Bone Joint Surg (Am) 1985;67(9):1321‑1327.
  2. Brattstrom H. Shape of the intercondylar groove normally and in recurrent dislocation of the patella. Acta Orthop Scand (suppl) 1964;68:134‑148.
  3. Vainionpaa S, Laasonen E, Patiala H, Rusanen M, Rokkannen P. Acute dislocation of the patella. Clinical, radiographic and operative findings in 64 consecutive cases. Acta Orthop Scand 1986;57(4):331‑333.
  4. Nietosvaara Y, Aalto K, Kallio PE. Acute patellar dislocation in children: Incidence and associated osteochondral fractures. J Pediatr Orthop 1994;14(4):513‑515.
  5. Baum C, Bensahal H. Luxation recidivante de la rotule chez l'enfant. Rev Chir Orthop 1973;59:583‑592.
  6. Rohlederer O. Atiologie and symptomatologie der praeluxio patellae. Zentralbl Chir 1951;76: 103‑115.
  7. Loff P, Friedebold G. Die habituelle patellarluxation als praarthrotische deformitat. Ergeb Chir 1969;52:60.
  8. Heywood A. Recurrent dislocation of the patella. J Bone Joint Surg 1961;43B:508‑517.
  9. Trillat A, Dejour HL, Coutette A. Diagnostic et traitement des subluxations recidivantes de la rotule. Rev Chir Orthop 1964;50:813‑824.
  10. Dupuis PV. La Torsion Tibiale. Paris: Masson et Cie; 1951.
  11. Hughston JC. Recurrent Subluxation and Dislocation of the Patella. AOA: Thesis. December 1962.
  12. Bizou H. Contribution a l'etude des desequilibres de l'appareil extenseur du genou dans le plan frontal. Toulouse, France: Thesis. 1966.
  13. Ficat P, Bizou H. Luxations recidivantes de la rotule. Rev Orthop 1967;53:721.
  14. Insall J, Falvo KA, Wise DW. Chondromalacia patellae. J Bone Joint Surg 1976;58A:1‑8.
  15. Koskinen SK, Kujala UM. Patellofemoral relationships and distal insertion of the vastus medialis muscle: A magnetic resonance imaging study in nonsymptomatic subjects and in patients with patellar dislocation. Arthroscopy 1992;8(4):465‑468.
  16. Carter C, Sweetnam R. Familial joint laxity and recurrent dislocation of the patella. J Bone Joint Surg 1958;40B:664.
  17. Jeffries TE. Recurrent dislocation of the patella due to abnormal attachment of the iliotibial tract. J Bone Joint Surg 1963;45B:740‑743.
  18. Bowker JHL, Thompson EB. Surgical treatment of recurrent dislocation of the patella. J Bone Joint Surg 1964;46A:1451‑1461.
  19. Crosby EB, Insall J. Recurrent dislocation of the patella. J Bone Joint Surg 1976;58A:9‑13.
  20. Dugdale TW, Renshaw TS. Instability of the patellofemoral joint in Down syndrome. J Bone Joint Surg (Am) 1986;68(3):405‑413.
  21. Diamond LS, Lynne D, Sigman B. Orthopedic disorders in patients with Down syndrome. Orthop Clin North Am 1981;12(1):57‑71.
  22. Mizuta H, Kubota K, Shiraishi M, Nakamura E, Takagi K, Iwatani N. Recurrent dislocation of the patella in Turner's syndrome. J Pediatr Orthop 1994;14(1):74.
  23. Ikegawa S, Sakaguchi R, Kimizuka M, Yanagisako Y, Tokimura F. Recurrent dislocation of the patella in Kabuki make‑up syndrome. J Pediatr Orthop 1993;13(2):265‑267.
  24. Weber W, Janek C, Mcleod P, Nelson C, Thompson J. Efficacy of various forms of fixation of transverse fractures of the patella. J Bone Joint Surg 1980;62A:215‑220.
  25. Mankin H. The response of articular cartilage to mechanical injury. J Bone Joint Surg 1982; 64A:460.
  26. Maquet P, Simonet J, Marchin PD. Biomechanique du genou et gonarthrose. Rev Chir Orthop 1967;53:111.
  27. Hawkins RJ, Bell RH, Anisette G. Acute patellar dislocations. The natural history. Am J Sports Med 1986;14(2):117‑120.
  28. Corso SJ, Thal R, Forman D. Locked patellar dislocation with vertical axis rotation. A case report. Clin Orthop 1992;279:190‑193.
  29. Lance E, Deutsch AL, Mink JH. Prior lateral patellar dislocation: MR imaging findings. Radiology 1993;189(3):905‑907.
  30. Virolainen H, Visuri T, Kuusela T. Acute dislocation of the patella: MR findings. Radiology 1993;189(1):243‑246.
  31. Larsen E, Lauridsen F. Conservative treatment of patellar dislocations. Clin Orthop 1982;171: 131‑136.
  32. Hawkins R, Bell R, Anisette G. Acute patellar dislocations. The natural history. Am J Sports Med 1986;14:117‑120.
  33. Vainionpaa S, Laasonen E, Silvennoinen T, Vasenius J, Rokkanen P. Acute dislocation of the patella. A prospective review of operative treatment. J Bone Joint Surg (Br) 1990;72(3):366‑369.
  34. Cofield R, Bryan R. Acute dislocation of the patella. Results of conservative treatment. J Trauma 1977;17:526‑531..
  35. Cash J, Hughston J. Treatment of acute patellar dislocation. Am J Sports Med 1988;16(3): 244‑250.
  36. Bigos SJ, McBride GG. The isolated lateral retinacular release in the treatment of patellofemoral disorders. Clio Orthop (June) 1984;(186):75‑80.
  37. Dainer R, Barrack R, Buckley S, Alexander A. Arthroscopic treatment of acute patellar dislocations. Arthroscopy 1988;4(4):267‑271.
  38. Christensen F, Soballa K, Snerum L. Treatment of chondromalacia patellae by lateral retinacular release of the patella. Clin Orthop 1988;234:145‑7.47.
  39. Fulkerson J, Schutzer S, Ramsby G, Bernstein R. Computerized tomography of the patellofemoral joint before and after lateral release or realignment. Arthroscopy 1987;(1):19‑24.
  40. Jackson AM. Recurrent dislocation of the patella (Editorial). J Bone Joint Surg (Br) 1992; 74(1):2‑4.
  41. Ficat P. Pathologic Femoro‑Patellaire. Paris: Masson et Cie; 1970.
  42. Andersen PT. Congenital deformities of the knee joint in dislocation of the patella and a chondrodysplasty. Acta Orthop Scand 1958;28:27‑50.
  43. Horwitz T. Recurrent or habitual dislocations of the patella. J Bone Joint Surg 1937;19A:1027.
  44. Macnab I. Recurrent dislocation of the patella. J Bone Joint Surg 1952;34A:957.
  45. Fairbank HAT. Internal derangement of the knee in children. Proc R Soc 1937;3:11.
  46. Apley AG. The diagnosis of meniscus injuries. J Bone Joint Surg 1947;29:78.
  47. Smillie IS. Injuries of the Knee Joint. Baltimore: Williams & Wilkins; 1962.
  48. Trillat A, Dejour H. Les fractures chondro‑osseuses du versant articulair interne de la rotule. Rev Chir Orthop 1967;53:331‑342.
  49. Arnbjornsson A, Egund N, Rydling O, Stockerup R, Ryd L. The natural history of recurrent dislocation of the patella. Long‑term results of conservative and operative treatment. J Bone Joint Surg (Br) 1992;74(1):140‑142.
  50. Cerullo G, Puddu G, Conteduca A, Ferriti A, Mariani P. Evaluation of the results of extensor mechanism reconstruction. http://www.ncbi.nlm.nih.gov/pubmed Am J Sports Med 1988;16(2):93‑96.
  51. Cox JS. Evaluation of the Roux‑Elmslie‑Trillat procedure for knee extensor realignment. Am J Sports Med 1982;10(5):303‑313.
  52. Riegler HF. Recurrent dislocations and subluxations of the patella. Clin Orthop 1988;227: 201‑209.
  53. Turba J. Formal extensor mechanism reconstruction. Clin Sports Med 1989;8(2):297‑317.
  54. Miller R, Bartlett J. Recurrent patella dislocation treated by closed lateral retinacular release. Aust NZJ Surg 1993;63(3):200‑202.
  55. Aglietti P, Pisaneschi A, De Biase P. Recurrent dislocation of patella: Three kinds of surgical treatment. Ital J Orthop Traumatol 1992;18(1):25‑36.
  56. Gomes JL. Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: A preliminary report. Arthroscopy 1992;8(3):335‑340.
  57. Avikainen VJ, Nikko RK, Seppanen‑Lehmonen TK. Adductor magnus tenodesis for patellar dislocation. Technique and preliminary results. Clin Orthop 1993;297:12‑16.
  58. Green JP, Waugh W. Congenital lateral dislocation of the patella. J Bone Joint Surg 1968;50B: 285‑289.
  59. Malek R. Luxations de la rotule et retractions quadricipitales. Paris: Comm. 42nd Contres S.O.F.C.O.T.; November 8‑11, 1967.
  60. Roux D. Luxation habituelle de la rotule. Traitement operatoire. Rev Chir (Paris) 1888;8:682‑689.
  61. Benoist JP, Ramadier JO. Luxations et subluxations de la rotule. Rev Chir Orthop 1969;55: 1089‑1099.
  62. Rutt A. Die patellaluxation in ihren verschiedenen formen and deren pathomechnik. Z Orthop 1972;110:235‑241.
  63. Ober RR. Recurrent dislocation of the patella. Am J Surg 1939;43:497.
  64. Williams PF. Quadriceps contracture. J Bone Joint Surg 1968;50B:278‑284.
  65. Hnevkovsky O. Progressive fibrosis of the vastus intermedius in children. J Bone Joint Surg 1961; 43B:318.
  66. Gunn DR. Contracture of the quadriceps muscle. J Bone Joint Surg 1964;46B:492‑497.
  67. Karlen A. Congenital fibrosis of the vastus intermedius muscle. J Bone Joint Surg 1964;46B: 488‑491.
  68. Lloyd‑Roberts GC, Thomas TG. The etiology of quadriceps contracture in children. J Bone Joint Surg 1964;46B:498‑502.
  69. Malek R. Retractions quadricipitales et injections intramusculaires chez l’enfant. Ann Chir Inf 1966;7:85‑91.
  70. Conn HR. A new method of operative reduction for congenital dislocation of the patella. J Bone Joint Surg 1925;7:370.
  71. Stern M. Persistent congenital dislocation of the patella. J Int Coll Surg 1964;41:654.
  72. Storen H. Congenital complete dislocation of the patella causing serious disability in childhood: The operative treatment. Acta Orthop Scand 1965;36:301‑313.
  73. Goldthwait JE. Permanent dislocation of the patella. Ann Surg 1899;29:62.
  74. Gan GX, Lee EH, Bose K. Surgical management of congenital and habitual dislocation of the patella. J Pediatr Orthop 1990;10(2):255‑260.
  75. Langenskiold A, Ritsila V. Congenital dislocation of the patella and its operative treatment. J Pediatr Orthop 1992;12(3):315‑323.
  76. Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP. Anatomy and biomechanics of the medial patellofemoral ligament. The Knee 2003;10(3):215-20.
  77. Bicos J, Fulkerson JP, Amis A. Current concepts review: the medial patellofemoral ligament. The American journal of sports medicine 2007;35(3):484-92.
  78. Elias JJ, Cosgarea AJ. Technical errors during medial patellofemoral ligament reconstruction could overload medial patellofemoral cartilage: a computational analysis. The American journal of sports medicine 2006;34(9):1478-85.
  79. Fithian DC, Paxton EW, Post WR, Panni AS. Lateral retinacular release: a survey of the International Patellofemoral Study Group. Arthroscopy 2004;20(5):463-8.
  80. Goutallier D, Bernageau J, Lecudonnec B. [The measurement of the tibial tuberosity. Patella groove distanced technique and results (author's transl)]. Revue de chirurgie orthopedique et reparatrice de l'appareil moteur 1978;64(5):423-8.
  81. Jones DG, Peterson L. Autologous chondrocyte implantation. The Journal of bone and joint surgery 2006;88(11):2502-20.
  82. Lattermann C, Toth J, Bach BR, Jr. The role of lateral retinacular release in the treatment of patellar instability. Sports medicine and arthroscopy review 2007;15(2):57-
  83. Minas T. Autologous chondrocyte implantation for focal chondral defects of the knee. Clinical orthopaedics and related research 2001(391 Suppl):S349-61.
  84. Nomura E, Horiuchi Y, Kihara M. Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. The Knee 2000;7(2):121-7.
  85. Panni AS, Tartarone M, Patricola A, Paxton EW, Fithian DC. Long-term results of lateral retinacular release. Arthroscopy 2005;21(5):526-31.
  86. Senavongse W, Amis AA. The effects of articular, retinacular, or muscular deficiencies on patellofemoral joint stability. J Bone Joint Surg Br 2005;87(4):577-82.  
  87. Schottle PB, Scheffler SU, Schwarck A, Weiler A. Arthroscopic medial retinacular repair after patellar dislocation with and without underlying trochlear dysplasia: a preliminary report. Arthroscopy 2006;22(11):1192-8.
  88. Tom A, Fulkerson J. Restoration of native MPFL support after patella dislocation. Sports medicine and arthroscopy review 2007;15(2):68-71.
  89. Verdonk R, Jansegers E, and Stuyts B. Trochleoplasty in the dysplastic knee trochlea. Knee Surg Sports Traum and Arthrosc 13: 529-533, 2005

Figure 10.1. Radiograph of patella alta in a 20‑year‑old woman with multiple episodes of patellar dislocation. LT/LP = 1.67.

Figure 10.2. Medial facet articular injury is common after relocation of a dislocated patella (Photo courtesy of David Burstein, Avon, Connecticut.)

Figure 10.3. The apprehension sign is characteristic of recurrent dislocation.

Figure 10.4. Marked medial retinacular soft‑tissue cal­cification in a patient with a history of recurrent dislo­cations.

Figure 10.5. The subchondral outline of the medial facet is interrupted, suggesting an osteochondral fracture rather than soft‑tissue calcification.

Figure 10.6. Patient with several episodes of recur­rent dislocation. A small fragment of bone is pulled away from the medial patellar border (small arrow) at the level of attachment of the medial patellofemoral liga­ment. The density in the lateral joint line has the ap­pearance of a loose body (large arrow).

Figure 10.7. A, Patella dislocation can cause considerable medial facet damage. These arthroscopic views demonstrate medial facet chondral damage caused by patellar dislocation. B, After resection of cartilage flaps and microfracture of the exposed subchondral bone to induce fibrocartilage resurfacing, the patient experi­enced substantial relief. In this case, there was satisfactory patella alignment.

Figure 10.8. A, Anteroposterior radiographic view of patient with congenital dislocation of the patella. Note the lateral situation of the patella and particularly the medial tibial hypoplasia. B, Lateral radiographic view of same patient. Even with this slight degree of flexion, the patella is disappearing behind the condyles.

Figure 10.9. Axial view of congenital dislocation of the right patella. The ossific nucleus can be seen lying along the lateral condyle. Note also the difference in sulcus depth on the right compared with the left.

Figure 10.10. Acquired dislocation due to quadriceps fibrosis.

Figure 10.11. Lateral view showing gross displacement of the patella in which the lateral facet is posterior to the central ridge.

Figure 10.12. Computerized tomography reveals the trochlear dysplasia that results from chronic patellar dislocation.

Figure 10.13. A, Anteroposterior view of a 56‑year‑old woman with permanent dislocation of the patella. The lateral compartment shows nearly complete loss of articular cartilage. B, Lateral radiograph of the same patient with the knee flexed 55 degrees. The patella is hidden lateral to the condyle and is not visualized on this projection. C, Axial view of the same patient showing complete lateral dislocation of the patella, which is half‑moon in shape, conforming now to the lateral femoral condyle rather than to the trochlear sulcus.

Figure 10.14. Technique of quadricepsplasty. A, Lateral parapatellar skin incision. B, Systematic searching for and sectioning abnormal bands. 1, Sectioning of the fascia lata when necessary; 2, division of any fascial slips from the fascia lata to the vastus lateralis; 3, sectioning any insertion from the fascia lata into the patella; 4, sectioning any abnormal fibrous bands in the vastus lateralis; and 5, separation of the vastus lateralis from the rectus femoris. This division should extend down to and include separation of the vastus lateralis from the patella. C, Division of any fibrous tissue from the intermedius muscle. S, synovial membrane; 2, incision in the synovium in order to explore the joint. D, Z‑plasty elongation of the quadriceps tendon resutured with the knee in 90 degrees of flexion and reinforced by the vastus lateralis. Reprinted with permission from Ficat P. Pathologie Fémoro‑Patellaire. Paris: Masson et Cie; 1970.

Figure 10.15. Same patient as seen in Figure 10.8, 2 years after quadricepsplasty. Note that the patella is well centered, and the trochlear groove is developing nicely.

Figure 10.16  Autogenous or allogeneic tendon may be used to do a tendon graft stabilization of the patella, reconstructing the MPFL component of the medial retinaculum .

 


        

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