Analysis of Two Different Techniques for Treatment of Patellar Dislocation Due to Fibrous Quadriceps Muscle in Children

Abstract

Objective: To evaluate the clinical and functional results of two surgical treatments of patellar dislocation in children. Material and Methods: A prospective study was undertaken from January 1995 to December 2009. Pre-postoperatively, the clinical and roentgenographic examinations were performed. Patellar dislocation was classified according to Bensahel's criteria. There were two surgical techniques performed: 1) the iliotibial tract passing through patella (ITT), and 2) transferring vastus medialis oblique muscle to superior border patella (VMO). Lateral retinacula were released to restore the tension of the medial retinacula and quadricepsplasty was used in all patients. The results of the operations were classified according to Kujala's functional knee-scoring systems. Results: 128 patients (132 knees) were operated. There were 20 males and 108 females. 94 knees (71.2%) were Type 1, and 38 knees (28.8%) were Type 2. The ITT was in 74 patients (76 knees), and VM was in 54 patients (56 knees). Clinical signs, imaging finding before and after the operation and operative results of these patients were operated with ITT and VM with no significant difference (p > 0.05). Overall, we attained excellent results in 95 knees (72.0%), good results in 30 knees (22.7%), and fair results in 7 knees (5.3%). There have been no poor results or recurrences so far. Conclusion: These techniques are simple, safe and effective in skeletally immature children. Long-term follow-up of these patients was operated ITT and these patients which were operated VMO were not different, but time for operation was: ITT: 65 minutes, and VMO: 55 minutes.