Habitual patellar dislocation 40 years after failed conservative treatment: A case report

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Patellar dislocation is typically linked to congenital abnormalities or joint laxity, rarely caused by trauma.
• Chronic, habitual patellar dislocation can persist for decades without significant bone morphology changes.
• Long-term patellofemoral instability impacts patient function and quality of life.

Observation:

• A 52-year-old male presented with a 40-year history of habitual patellar dislocation following childhood trauma.
• Despite no abnormal bone morphology, the patient experienced recurrent lateral patellar displacement during knee flexion.
• Pre-operative Lysholm and Kujala scores indicated moderate functional limitation (77 and 73, respectively).

Findings:

• A combined surgical technique, including Elmslie-Trillat procedure, lateral release, and medial patellofemoral ligament (MPFL) reconstruction, was performed.
• Post-operatively, the patient experienced significant improvement in patellar stability and function.
• At 8 months, Lysholm and Kujala scores improved to 97 and 93, respectively, with resolution of instability.

Implications:

• This case demonstrates the efficacy of a multi-modal surgical strategy for treating chronic habitual patellar dislocation.
• Combined procedures can successfully restore patellofemoral stability and function in long-standing cases.
• The findings suggest that surgical intervention should be considered for chronic patellar instability, regardless of duration.