Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children

Abstract

e investigated the clinical outcome of a reconstructive procedure of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in four children (6 knees), with a minimum follow-up of four years. The technique involves transfer of the tendon of semitendinosus to the patella using the posterior onethird of the femoral insertion of the medial collateral ligament as a pulley. There was no recurrence of dislocation after surgery. The mean Kujala score at follow-up was 96.3 points. Radiological assessment showed that the congruence angle, the tilt angle and the lateral shift radio were restored to normal. The lateral and medial stress shift ratios and the Insall-Salvati ratio remained abnormal. We conclude that this technique can be recommended for the treatment of habitual or recurrent patellar dislocation in children, although hypermobility and patella alta are not fully corrected.

The Outcomes of Modified Fulkerson Osteotomy Procedure to Treat Habitual Patellar Dislocation Associated with High-Grade Trochlear Dysplasia

“…Habitual patellar dislocationis rare and often occurs during early childhood. Part of a recurrent patellar dislocation could develop into a habitual dislocation when the patellar dislocation occurs due to an external injury of the knee joint [5]. In agreement with most of the previous studies [5,6], the cases in this group consisted of patients whose knee patella was in the normal position when the knees were unbent and dislocated laterally when the knees were bent past 30° [ 6].…”

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

“…Galeazzi [29], Baker [2] used semitendinosus tenodesis passed through the patella for repair of recurrent dislocation of the patella in children. However, this technique has some complications, such as fracture or degeneration and hypermobility of the patella, and patella alta is not fully corrected [30].…”

Treatment of patellar instability in a case of hereditary onycho-osteodysplasia (nail-patella syndrome) with medial patellofemoral ligament reconstruction: A case report

“…A partial list of commonly employed methods includes double-strand gracilis autograft (13), combined medial patellofemoral ligament repair and medial patellotibial ligament reconstruction (14), single-strand middle third quadriceps tendon autograft (15), single-strand adductor magnus split tendon transfer (16), and adductor sling (17) and medial collateral ligament sling techniques (18). The aim of these surgical methods used in MPFL is to provide an effective reconstruction without impairment of normal knee function.…”