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Related Experiment Videos

Delayed proximal repair and distal realignment after patellar dislocation.

W P Garth1, D G DiChristina, G Holt

  • 1Sports Medicine Institute, University of Alabama at Birmingham 35233, USA.

Clinical Orthopaedics and Related Research
|August 16, 2000
PubMed
Summary

Surgical repair of the medial patellofemoral ligament and advancement of the medial patellomeniscal ligament, combined with Q angle normalization, successfully treated chronic patellar instability in athletes. Most patients regained full function without recurrent instability.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanics

Background:

  • Chronic patellar instability is a common sequela of traumatic patellar dislocation in athletes.
  • Distal malalignment and medial patellofemoral ligament (MPFL) attenuation contribute to persistent instability.
  • Conservative management often fails in cases of post-physial closure traumatic patellar dislocation.

Purpose of the Study:

  • To evaluate the efficacy of a combined surgical technique for treating chronic patellar instability in athletes with distal malalignment.
  • To assess functional outcomes, recurrent instability, and radiographic changes following MPFL repair and Q angle normalization.

Main Methods:

  • Surgical repair of MPFL tears at the site of disruption and advancement of the medial patellomeniscal ligament.

Related Experiment Videos

  • Tibial tubercle osteotomy to normalize the Q angle to 10 degrees and distal lateral retinacular release.
  • Evaluation of outcomes using the Turba criteria and International Knee Documentation Committee guidelines.

    • Main Results:

    • 90% of patients achieved good or excellent results with no recurrent instability at a minimum 24-month follow-up.
    • Mean patellofemoral congruence angle improved significantly from 20 to 0 degrees postoperatively.
    • Two patients reported fair subjective results with mild impairment during vigorous activity.

    Conclusions:

    • Combined surgical treatment of MPFL disruption, medial patellomeniscal ligament advancement, and Q angle correction is effective for chronic patellar instability.
    • This approach restores stability and improves patellofemoral congruence in athletes after failed conservative management.
    • Successful outcomes support this surgical strategy for athletes with traumatic patellar dislocation and distal malalignment.