Arthroscopic patellar "bankart" repair after acute dislocation

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Pediatric Orthopedics

Background:

• Patellar dislocation is frequent in skeletally immature patients, with controversial treatment for first-time events due to high recurrence rates.
• Recurrent instability and functional disability are significant concerns following initial patellar dislocations in this demographic.
• Open surgical techniques for medial restraints carry risks, including anterior knee pain and crepitus.

Observation:

• Acute patellar dislocations can result in avulsion of the medial patellofemoral ligamentous complex from the patella.
• Arthroscopic medial retinacular imbrication has shown promise for persistent instability.
• Direct primary repair of avulsed medial restraints is feasible.

Findings:

• A minimally invasive arthroscopic repair of the medial patellofemoral ligamentous complex using suture anchors and a horizontal mattress suture technique was successfully performed.
• This approach directly addresses ligamentous avulsion, potentially preventing recurrent patellar instability.
• The technique aims to restore normal knee anatomy and function with reduced surgical morbidity compared to open procedures.

Implications:

• Arthroscopic repair offers a less invasive alternative for acute patellar dislocations in skeletally immature patients.
• This technique may reduce the incidence of recurrent instability and associated functional deficits.
• Further studies are warranted to evaluate long-term outcomes and compare with conservative or open surgical management.