Surgical treatment of a chronically fixed lateral patella dislocation in an adolescent patient.

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  • Author(s): Li X;Li X; Nielsen NM; Zhou H; Stein BS; Shelton YA; Busconi BD
  • Source:
    Orthopedic reviews [Orthop Rev (Pavia)] 2013 Jun 10; Vol. 5 (2), pp. 45-7. Date of Electronic Publication: 2013 Jun 10 (Print Publication: 2013).
  • Publication Type:
    Case Reports
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Open Medical Publishing Country of Publication: United States NLM ID: 101524779 Publication Model: Electronic-Print Cited Medium: Print ISSN: 2035-8237 (Print) Linking ISSN: 20358164 NLM ISO Abbreviation: Orthop Rev (Pavia) Subsets: PubMed not MEDLINE
    • Publication Information:
      Publication: 2021- : [Scottsdale, AZ] : Open Medical Publishing
      Original Publication: Pavia, Italy : PagePress, 2009-
    • Abstract:
      Acute patellar dislocation or subluxation is a common cause for knee injuries in the United States and accounts for 2% to 3% of all injuries. Up to 49% of patients will have recurrent subluxations or dislocations. Importance of both soft tissue (predominantly, the medial patellofemoral ligament, MPFL, which is responsible for 60% of the resistance to lateral dislocation) and bony constraint of femoral trochlea in preventing subluxation and dislocation is well documented. Acute patella dislocation will require closed reduction and management typically consist of conservative or surgical treatment depending on the symptoms and recurrence of instability. Most patients are diagnosed and treated in a timely manner. We present a 15 years old male with a missed traumatic lateral patella dislocation during childhood. The patient presented as an adolescent with a chronically fixed lateral patella dislocation and was management with surgery. The key steps in the surgical reconstruction of this patient required first mobilizing the patella with a lateral retinacular release and V-Y lengthening of the shortened or contracted quadriceps tendon. Then a combination of MPFL reconstruction using the semitendinosis autograft, tibial tubercle osteotomy with anterio-medialization, and lateral facetectomy was performed. At the one-year follow-up, our patient had improved knee range of motion and decrease in pain. Chronically fixed lateral dislocated patella is a rare and complex problem to manage in older patients that will require a thorough work-up and appropriate surgical planning along with reconstruction.
    • Comments:
      Erratum in: Orthop Rev (Pavia). 2018 Dec 12;10(4):7968. (PMID: 30662689)
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    • Contributed Indexing:
      Keywords: Faulkerson procedure; MPFL reconstruction; patella dislocation; pediatric orthopedics
    • Publication Date:
      Date Created: 20130727 Date Completed: 20130726 Latest Revision: 20211021
    • Publication Date:
      20221213
    • Accession Number:
      PMC3718243
    • Accession Number:
      10.4081/or.2013.e9
    • Accession Number:
      23888199