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Habitual dislocation of the patella in flexion
1Royal Children's Hospital, Parkville, Victoria, Australia.
Summary
Quadricepsplasty for habitual patellar dislocation can be effective, but contractures may lead to redislocation. Quadriceps lengthening is crucial for successful treatment outcomes in patellofemoral instability.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanics
Background:
- Habitual dislocation of the patella in flexion presents a significant challenge in orthopedic practice.
- Previous surgical interventions, including quadricepsplasty, have been employed with varying success rates.
Purpose of the Study:
- To evaluate the long-term outcomes of quadricepsplasty in patients with habitual patellar dislocation.
- To identify factors contributing to treatment success and failure.
Main Methods:
- A retrospective review of 35 patients (35 knees, 8 bilateral) who underwent quadricepsplasty for habitual patellar dislocation.
- Average follow-up of 6 years and 9 months.
- Assessment of knee status, presence of contractures, and redislocation events.
Main Results:
- Contractures, particularly in the vastus lateralis, iliotibial tract, and rectus femoris, were commonly observed.
- Redislocation occurred in 12 knees.
- At follow-up, 79% of the knees were reported as normal.
Conclusions:
- Quadriceps lengthening, performed proximally, is an essential component of successful treatment for habitual patellar dislocation.
- Reformation of contractures and incomplete correction of the primary abnormality are key causes of treatment failure.