We report a prospective study of 55 patients with acute primary patellar dislocation, all treated by operation and followed up for at least two years. Diagnosis was based on the history of a lateral displacement, with medial tenderness and a positive apprehension test; redislocations were excluded. Before operation, the difference in lateral shift on skyline views of the injured and control patellae was highly significant. At operation, rupture of the medial retinaculum of the patella was seen in all but one case. There were medial marginal fractures of the patella in 23 cases. Subjective results of the operation were excellent or good in 44 of the 55 at two years with a redislocation rate of only 9%. Most patients were able to return to the same level of sporting activity as before the injury.
Bioabsorbable internal fixation by means of pins, tacks, screws and miniplates offers an alternative to metallic osteofixation for the stabilization of small bone fractures, osteotomies, ligament injuries and fusions in the hand. The advantages of using them include avoidance of metallic-implant-related long-term complications and a secondary removal operation. Currently the most commonly used devices are made of poly L-lactide (PLLA) and copolymers of polylactides (P(L/DL)LA) and polyglycolide (PLGA). In areas of mechanical stress, the use of ultra-high-strength self-reinforced devices is recommended. Biomechanical studies on fresh frozen bones have shown that the fixation rigidity achieved with self-reinforced devices approaches that of metallic osteofixation methods. The reliability of modern implants has been confirmed in several experimental and clinical studies.
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