Habitual patellar dislocation in children: Results of surgical treatment by modified four in one technique

Habitual patellar dislocation is a rare condition affecting children. The growth plates are open in children and any surgical intervention should take that in to consideration. We are describing a modified four in one technique for habitual patellar dislocation, which is a soft tissue procedure without the use of any implant.

In this study we included 6 children (4 females and 2 males) with open growth plates, which were diagnosed with habitual patellar dislocation. The average age of the patients were 9.6 years (range 5-13 years). Our technique included lateral retinaculum release, vastus medialis obliques (VMO) advancement, partial patellar tendon transposition and reconstruction of medial patellofemoral ligament (MPFL). Patients were evaluated with Kujala scoring pre and post operatively. The average follow up period was 12 months (range 7-24 months).

There were no recurrence of patellar instability in any of the cases. The mean Kujala score was 48 before surgery and it improved to 95 after 12 months of average follow-up after surgery.

We conclude that our method of treatment of habitual patellar dislocation by using modified four in one technique in children with open physis reproduced excellent functional outcome. It is simple, cheap and does not require any image guidance.

Level of evidence IV.