Sunnassee Yoshvin1, Edward P Southern, Yi Wang. 1. Department of Orthopedics, Building No.6, 8th floor, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Orthopedics and Traumatology, 197, Ruijin Er Lu, Shanghai, People's Republic of China, Yoshvin@live.com.
Abstract
BACKGROUND: Congenital patellar dislocation is a rarely encountered condition and is readily treated in childhood to prevent lasting disability, knee pain, decreased range of motion and ambulation problems. This condition is very rarely seen in skeletally mature patients, and the treatment of the condition represents a challenge to the orthopedic surgeon. SURGICAL TECHNIQUE AND METHODS: Patients were treated with soft tissue reconstruction and tibial tubercle transfer with or without a prior medial close-wedge distal femoral osteotomy, depending on the degree of valgus deformity. We, then, searched the database of our orthopedics center for cases of congenital patellar dislocation in skeletally mature patients who were surgically treated. We collected a total of five knees and analyzed the cases according to the type of surgery performed and difference between pre- and postoperative functions. RESULTS: Five knees with congenital patellar dislocation were treated. The mean age of the patients was 29.6 years, and mean follow-up time was 4.3 years. Mean preoperative range of motion was 65°, and it increased to a mean of 105.5° after surgical treatment. The mean preoperative Kujala score was 29.2 and increased to 67.2 after surgical treatment. DISCUSSION: Congenital patellar dislocations that are allowed to proceed to adulthood are difficult to treat, and surgical treatment depends on the degree of deformity of the patella and of the knee joint. This study shows that surgical treatment is able to correct the deformity and provide better knee function.
BACKGROUND:Congenital patellar dislocation is a rarely encountered condition and is readily treated in childhood to prevent lasting disability, knee pain, decreased range of motion and ambulation problems. This condition is very rarely seen in skeletally mature patients, and the treatment of the condition represents a challenge to the orthopedic surgeon. SURGICAL TECHNIQUE AND METHODS: Patients were treated with soft tissue reconstruction and tibial tubercle transfer with or without a prior medial close-wedge distal femoral osteotomy, depending on the degree of valgus deformity. We, then, searched the database of our orthopedics center for cases of congenital patellar dislocation in skeletally mature patients who were surgically treated. We collected a total of five knees and analyzed the cases according to the type of surgery performed and difference between pre- and postoperative functions. RESULTS: Five knees with congenital patellar dislocation were treated. The mean age of the patients was 29.6 years, and mean follow-up time was 4.3 years. Mean preoperative range of motion was 65°, and it increased to a mean of 105.5° after surgical treatment. The mean preoperative Kujala score was 29.2 and increased to 67.2 after surgical treatment. DISCUSSION: Congenital patellar dislocations that are allowed to proceed to adulthood are difficult to treat, and surgical treatment depends on the degree of deformity of the patella and of the knee joint. This study shows that surgical treatment is able to correct the deformity and provide better knee function.