Mini-Open Medial Reefing and Arthroscopic Lateral Release for the Treatment of Recurrent Patellar Dislocation

Abstract

Our mini-open technique provides anatomical restoration with limited morbidity and cosmetically appealing results. Furthermore, our redislocation rates compare favorably with traditional, more extensile open approaches.

Surgical Treatment of Acute Patella Dislocations: Review of 13 Consecutive Cases from Keller Army Hospital

“…However, others have reported lesions of the VMO [4,5,[8][9][10] as well as osteochondral lesions [5,8,[11][12][13][14][15][16]. Our results are consistent with these reports, as we found MPFL tears in all.…”

“…Disruption of this ligament has been termed "the essential lesion" of traumatic patellar dislocation [5]. In addition, vastus medialis obliquus (VMO) lesions [4,5,[8][9][10] and osteochondral defects [5,8,[11][12][13][14][15][16] have also been reported with this injury. The purpose of this study is to evaluate our experience with surgical management of acute traumatic patellar dislocations.…”

Arthroscopic Patellar Plication: An Option for Patellar Instability with Femoral Trochlear Dysplasia

“…This technic was first described in 2001 by Hallbrecht [5] and his follow-up report in 2009 of those patients showed good results [5]. Several reports comparing open plication, [6,7] arthroscopic assisted [8,9], and arthroscopic plication [10] reported similar results between them. There are some references concerning the use of this technic in patients with trochlear dysplasia, like the study of Schottle et al [11] reporting similar results when comparing low grade dysplasia (Type A and B) and patients with no dysplasia.…”

Modern management of patellar instability

“…A multitude of surgical options have been described, ranging from repair, imbrication (reefing) or plication of the medial retinacular structures [57][58][59]. These procedures can be performed in an open, arthroscopic or as an open-arthroscopic technique.…”

“…Most of these procedures described are commonly performed in conjunction with a lateral release, and results have been encouraging. Results of these repairs have shown re-dislocation rates of up to 89 % [57][58][59][60][61][62] A recent study demonstrated that medial reefing alone yielded similar results to combined procedures of medial reefing and lateral release, with no incidence of redislocation or subluxation [63]. Desio et al [8] explains why there is no biomechanical advantage to performing a lateral release.…”