Management of Fixed Dislocation of the Patella

Abstract

Congenital dislocation of the patella is a rare condition which manifests as a permanent and irreducible patella fixed on the lateral aspect of the femoral condyle, usually present at birth. This condition is to be distinguished from habitual or obligate dislocation, in which the patella dislocates and relocates from its normal position in the trochlear groove spontaneously with flexion and extension of the knee. Congenital dislocation of the patella is frequently associated with a flexion contracture at the knee, genu valgus, foot deformity and external tibial torsion, along with various conditions including arthrogryposis, Down syndrome, and nail-patella syndrome, among others. Surgical correction is the only definitive treatment for this condition, which typically includes lateral release, medial stabilization, distal patellar tendon realignment, and proximal extensor lengthening if needed. Outcomes following surgical correction are generally satisfactory, with an improvement in function, range of motion, and quality of life for patients. The aim of this paper is to review the current understanding of congenital and habitual dislocation of the patella and provide an updated overview of the diagnosis and surgical management of these conditions.

Treatment of Chronic Dislocated Patella in a Skeletally Mature Down Syndrome Patient

“…The patient's irreducible patella could also be attributed to a tight LR because a tight LR could predispose to lateral patella subluxation 25 . Components of the LR can be released to various extents 15,26-28 because of the tight LR causing complications 11 . LL was performed to release the tight LR and was combined with MPFLR to achieve normal realignment of the patella to prevent patellar malalignment and hypermobility postoperatively.…”