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- Title
The clinical and radiological results of individualized surgical treatment depending on pathologic abnormalities in recurrent patellar dislocation: low recurrence rate, but unintended patella baja.
- Authors
Lee, Do Kyung; Wang, Joon Ho; Kang, Seung Hoon; Kim, Jun Ho; Haque, Russel; Lee, Byung Hoon
- Abstract
<bold>Purpose: </bold>To evaluate the clinical and radiological outcomes and chondral lesion change using individualized surgery for recurrent patellar dislocation.<bold>Methods: </bold>A total of 31 knees with recurrent patellar dislocation underwent surgery depending on individual pathologic abnormalities. Pathologic abnormalities including medial laxity, lateral tightness, increased tibial tuberosity (TT)-to-trochlear groove distance (>20 mm), and patella alta (Caton-Deschamps ratio >1.2) were evaluated in each patient. The abnormalities were corrected through medial patellofemoral ligament reconstruction, TT distalization, TT anteromedialization, and lateral retinacula release. The mean follow-up period was 33 months.<bold>Results: </bold>There was one recurrent case (3.2%), requiring additional surgery. The mean Kujala scores were significantly (P = 0.002) improved from 75.8 (SD 12.4) to 84.6 (SD 13.1). Tegner scores were significantly improved from 3.7 (range 1-9) to 5.4 (range 2-9) (P < 0.001), as were and visual analogue scale pain scores from 4.7 (SD 2.5) to 2.6 (SD 2.2) (P = 0.001). Caton-Deschamps ratio was significantly decreased from 1.1 (SD 0.2) to 0.9 (SD 0.1) (P < 0.001), regardless of TT distalization. Chondral lesions of the patella and trochlear groove were improved or maintained in 57.1 and 71.4% of patients, respectively.<bold>Conclusion: </bold>Individualized surgery in recurrent patellar dislocation was effective and safe with a low recurrence rate. However, the possibility of unintended patella baja, which might be related to post-operative anterior knee pain, should be considered.<bold>Level Of Evidence: </bold>IV.
- Subjects
PATELLA dislocation; PATELLA; PATELLOFEMORAL joint; KNEE pain; POSTOPERATIVE care; JOINT hypermobility; SURGERY; THERAPEUTICS; KNEE surgery; TIBIA surgery; ARTICULAR ligament surgery; ARTHROSCOPY; JOINT dislocations; KNEE; ORTHOPEDIC surgery; POSTOPERATIVE period; RADIOGRAPHY; DISEASE relapse; RETROSPECTIVE studies
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2018, Vol 26, Issue 9, p2558
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-017-4697-1